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Tech Coloproctol. 2007 Jun;11(2):135-43. Epub 2007 May 25.

Open compared with closed haemorrhoidectomy: meta-analysis of randomized controlled trials.

Author information

1
School of Medicine and North Queensland Centre for Cancer Research, James Cook University, Townsville, QLD 4811, Australia. yikhong.ho@jcu.edu.au

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.

PMID:
17510742
DOI:
10.1007/s10151-007-0343-0
[Indexed for MEDLINE]

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