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Open compared with closed haemorrhoidectomy: meta-analysis of randomized controlled trials.
Tech Coloproctol 2007; 11(2):135-43TC

Abstract

AIMS

This review compares the most popular techniques in managing the wounds after excisional haemorrhoidectomy, which are either to lay the wounds open or to close them.

METHODS

Randomized controlled trials were identified from the major electronic databases using the search terms "hemorrhoid*" and "haemorrhoid*." Duration of operation, pain, length of hospital stay, time off work, time for wound healing, patient satisfaction, continence, manometry findings and complications were assessed. Quantitative meta-analysis was performed as appropriate or possible.

RESULTS

Six trials including 686 patients met the inclusion criteria. The median follow-up time ranged from 1.5 to 19.5 months. Quantitative meta-analysis showed that there was no significant difference in cure rates between the two techniques (relative risk, 1.4; 95% CI, 0.86 to 2.2; p=0.191). Open haemor-rhoidectomy was more quickly performed (weighted mean difference, 1.03 min; 95% CI, 0.51 to 1.54; p<0.001). Closed haemorrhoidectomy wounds showed faster healing (weighted mean difference, 1.2 weeks; 95% CI, 0.88 to 1.55; p<0.001). Hospital stay, maximum pain score, total and individual complication rates were not significantly different.

CONCLUSIONS

Apart from faster wound healing after closed haemorrhoidectomy, open and closed techniques appeared equally effective and safe. However, there were only a few studies which presented information in different ways, and statistical heterogeneity was high.

Authors+Show Affiliations

School of Medicine and North Queensland Centre for Cancer Research, James Cook University, Townsville, QLD 4811, Australia. yikhong.ho@jcu.edu.auNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Meta-Analysis

Language

eng

PubMed ID

17510742

Citation

Ho, Y H., and P G. Buettner. "Open Compared With Closed Haemorrhoidectomy: Meta-analysis of Randomized Controlled Trials." Techniques in Coloproctology, vol. 11, no. 2, 2007, pp. 135-43.
Ho YH, Buettner PG. Open compared with closed haemorrhoidectomy: meta-analysis of randomized controlled trials. Tech Coloproctol. 2007;11(2):135-43.
Ho, Y. H., & Buettner, P. G. (2007). Open compared with closed haemorrhoidectomy: meta-analysis of randomized controlled trials. Techniques in Coloproctology, 11(2), pp. 135-43.
Ho YH, Buettner PG. Open Compared With Closed Haemorrhoidectomy: Meta-analysis of Randomized Controlled Trials. Tech Coloproctol. 2007;11(2):135-43. PubMed PMID: 17510742.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Open compared with closed haemorrhoidectomy: meta-analysis of randomized controlled trials. AU - Ho,Y H, AU - Buettner,P G, Y1 - 2007/05/25/ PY - 2006/11/26/received PY - 2007/01/29/accepted PY - 2007/5/19/pubmed PY - 2007/7/20/medline PY - 2007/5/19/entrez SP - 135 EP - 43 JF - Techniques in coloproctology JO - Tech Coloproctol VL - 11 IS - 2 N2 - AIMS: This review compares the most popular techniques in managing the wounds after excisional haemorrhoidectomy, which are either to lay the wounds open or to close them. METHODS: Randomized controlled trials were identified from the major electronic databases using the search terms "hemorrhoid*" and "haemorrhoid*." Duration of operation, pain, length of hospital stay, time off work, time for wound healing, patient satisfaction, continence, manometry findings and complications were assessed. Quantitative meta-analysis was performed as appropriate or possible. RESULTS: Six trials including 686 patients met the inclusion criteria. The median follow-up time ranged from 1.5 to 19.5 months. Quantitative meta-analysis showed that there was no significant difference in cure rates between the two techniques (relative risk, 1.4; 95% CI, 0.86 to 2.2; p=0.191). Open haemor-rhoidectomy was more quickly performed (weighted mean difference, 1.03 min; 95% CI, 0.51 to 1.54; p<0.001). Closed haemorrhoidectomy wounds showed faster healing (weighted mean difference, 1.2 weeks; 95% CI, 0.88 to 1.55; p<0.001). Hospital stay, maximum pain score, total and individual complication rates were not significantly different. CONCLUSIONS: Apart from faster wound healing after closed haemorrhoidectomy, open and closed techniques appeared equally effective and safe. However, there were only a few studies which presented information in different ways, and statistical heterogeneity was high. SN - 1123-6337 UR - https://www.unboundmedicine.com/medline/citation/17510742/Open_compared_with_closed_-haemorrhoidectomy:_meta_analysis_of_randomized_controlled_trials_ L2 - https://dx.doi.org/10.1007/s10151-007-0343-0 DB - PRIME DP - Unbound Medicine ER -