Scholarlink

Purpose <p>Stapled haemorrhoidopexy (SH) offers well-established short-term advantages over conventional haemorrhoidectomy (CH), but its long-term effectiveness remains controversial. This systematic review and meta-analysis aimed to compare long-term outcomes of SH versus CH in adult patients with grade II–IV haemorrhoids, incorporating Trial Sequential Analysis (TSA).</p> Methods <p>MEDLINE, EMBASE and CENTRAL were searched from January 2001 to October 2025 for randomized controlled trials (RCTs) comparing SH and CH with a minimum follow-up of 12&#xa0;months. Two reviewers independently performed study selection, data extraction and risk-of-bias assessment (RoB-2). Primary outcomes included recurrence, reintervention, anal function, and quality of life (QoL). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. TSA was applied to overall recurrence.</p> Results <p>Seventeen RCTs including 1,041 SH and 1,031 CH patients were analysed. SH was associated with a higher risk of overall recurrence compared with CH (RR = 1.56,95%CI = 1.00–2.44;I<sup>2</sup> = 48%). TSA showed that the accrued information size (1,913 patients) did not reach the required information size (2,608 patients), indicating that current evidence remains underpowered. Prolapse-related recurrence was significantly more frequent after SH (RR = 3.28,95%CI = 1.49–7.25;I<sup>2</sup> = 12%), whereas bleeding-related recurrence did not differ between groups (RR = 1.20,95%CI = 0.63–2.26;I<sup>2</sup> = 23%). No significant differences were found for reintervention, persistent anal pain, functional impairment or QoL.</p> Conclusion <p>SH is associated with a higher risk of long-term recurrence, particularly prolapse-related recurrence, compared with CH, while long-term pain, functional outcomes and QoL appear broadly comparable. These findings suggest that, although SH may remain an option for selected patients, CH provides more durable anatomical correction, and procedural choice should balance early recovery against long-term durability.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Long-term outcomes of stapled haemorrhoidopexy versus conventional haemorrhoidectomy: An updated systematic review, meta-analysis and trial-sequential analysis of randomized controlled trials

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年1月14日

查看全文
  • Sara Lauricella,
  • Francesco Brucchi,
  • Gianluca Mascianà,
  • Giovan Battista Levi Sandri,
  • Filippo Banchini,
  • Gianlorenzo Dionigi,
  • Diletta Cassini,
  • Massimiliano Casati,
  • Roberto Cirocchi

摘要

Purpose

Stapled haemorrhoidopexy (SH) offers well-established short-term advantages over conventional haemorrhoidectomy (CH), but its long-term effectiveness remains controversial. This systematic review and meta-analysis aimed to compare long-term outcomes of SH versus CH in adult patients with grade II–IV haemorrhoids, incorporating Trial Sequential Analysis (TSA).

Methods

MEDLINE, EMBASE and CENTRAL were searched from January 2001 to October 2025 for randomized controlled trials (RCTs) comparing SH and CH with a minimum follow-up of 12 months. Two reviewers independently performed study selection, data extraction and risk-of-bias assessment (RoB-2). Primary outcomes included recurrence, reintervention, anal function, and quality of life (QoL). Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. TSA was applied to overall recurrence.

Results

Seventeen RCTs including 1,041 SH and 1,031 CH patients were analysed. SH was associated with a higher risk of overall recurrence compared with CH (RR = 1.56,95%CI = 1.00–2.44;I2 = 48%). TSA showed that the accrued information size (1,913 patients) did not reach the required information size (2,608 patients), indicating that current evidence remains underpowered. Prolapse-related recurrence was significantly more frequent after SH (RR = 3.28,95%CI = 1.49–7.25;I2 = 12%), whereas bleeding-related recurrence did not differ between groups (RR = 1.20,95%CI = 0.63–2.26;I2 = 23%). No significant differences were found for reintervention, persistent anal pain, functional impairment or QoL.

Conclusion

SH is associated with a higher risk of long-term recurrence, particularly prolapse-related recurrence, compared with CH, while long-term pain, functional outcomes and QoL appear broadly comparable. These findings suggest that, although SH may remain an option for selected patients, CH provides more durable anatomical correction, and procedural choice should balance early recovery against long-term durability.