Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .
Stapled and Open Hemorrhoidectomy: Randomized Controlled Trial of Early Results
The aim of the study was to compare the early results in 52 patients r and omly allocated to undergo either stapled or open hemorrhoidectomy . Seventy-four patients with grade III and IV hemorrhoids were r and omly allocated to undergo either stapled ( 37 patients ) or open ( 37 patients ) hemorrhoidectomy . Stapled hemorrhoidectomy was performed with the use of a circular stapling device . Open hemorrhoidectomy was accomplished according to the Milligan-Morgan technique . Postoperative pain was assessed by means of a visual analogue scale ( V.A.S. ) . Recovery evaluation included return to pain-free defecation and normal activities . A 6-month clinical follow-up and a 17.5 ( 10 to 27)-month median telephone follow-up was obtained in all patients . Operation time for stapled hemorrhoidectomy was shorter ( median 25 [ range 15 to 49 ] minutes versus 30 [ range 20 to 44 ] minutes , p = 0.041 ) . Median ( range ) V.A.S. scores in the stapled group were significantly lower ( V.A.S. score after 4 hours : 4 [ 2 to 6 ] versus 5 [ 2 to 8 ] , p = 0.001 ; V.A.S. score after 24 hours : 3 [ 1 to 6 ] versus 5 [ 3 to 7 ] , p = 0.000 ; V.A.S. score after first defecation : 5 [ 3 to 8 ] versus 7 [ 3 to 9 ] , p = 0.000 ) . Resumption of pain-free defecation was significantly faster in the stapled group ( 10 [ 6 to 14 ] days vs 12 [ 9 to 19 ] days , p = 0.001 ) . At follow-up 4 weeks and 6 months postoperatively the median ( range ) symptom severity score was similar in both groups ( 1 [ 0 to 2 ] versus 0 [ 0 to 3 ] , p = 0.150 and 0 [ 0 to 2 ] versus 0 [ 0 to 2 ] , p = 0.731 ) . At long-term follow-up occasional pain was present in 6/37 ( 16.2 ) patients in the stapled group and 7/37 ( 18.9 % ) in the Milligan-Morgan group ( p = 1.000 ) ; episodes of bleeding were reported by 8/37 ( 21.6 % ) patients in the stapled group and 5/37 ( 13.5 % ) patients in the Milligan-Morgan group ( p = 0.542 ) . No problems related to continence and defecation were reported in either group . Patients were satisfied with the operation in 33/37 ( 89.2 % ) cases in the stapled group and 31/37 ( 83.8 % ) cases in the Milligan-Morgan group ( p = 0.735 ) . Hemorrhoidectomy with a circular staple device is easy to perform and achieves better results than the Milligan-Morgan technique in terms of postoperative pain and recovery . Comparable results are obtained at long-term follow-up
Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .