Our Summary

This study compared two different surgical treatments for hemorrhoids: stapled hemorrhoidectomy (SH) and transanal hemorrhoidal dearterialization (THD). The researchers looked at nine different trials, involving 1077 patients, and studied things like how long the surgery took, how much pain patients had afterwards, how long they stayed in the hospital, and how quickly they were able to return to work. They also looked at how often the hemorrhoids came back after treatment.

They found that patients who had the SH surgery had a higher rate of bleeding than those who had the THD treatment. However, there was no significant difference between the two treatments in terms of surgery time, post-surgery pain, hospital stay, and return-to-work time. They also found that hemorrhoids were more likely to come back after the THD treatment than after the SH treatment.

In simple terms, both treatments work well for treating hemorrhoids, but the SH treatment seems to have a lower chance of the hemorrhoids coming back. However, the researchers say that more studies are needed to confirm these findings.

FAQs

  1. What is the difference between stapled hemorrhoidectomy (SH) and transanal hemorrhoidal dearterialization (THD) in terms of bleeding rate and recurrence rate?
  2. Was there any significant difference found between SH and THD in terms of operating time, postoperative pain, hospital time, and return-to-work time?
  3. Are both SH and THD effective for treating hemorrhoids, and which one produces better outcomes in terms of a lower recurrence rate?

Doctor’s Tip

A doctor might tell a patient undergoing a hemorrhoidectomy that stapled hemorrhoidectomy (SH) has a lower recurrence rate compared to transanal hemorrhoidal dearterialization (THD). It is important to follow post-operative care instructions, including proper wound care and pain management, to promote healing and reduce the risk of complications. Additionally, regular follow-up appointments with your healthcare provider are important to monitor your recovery progress and address any concerns.

Suitable For

Patients with severe or recurrent hemorrhoids that have not responded to conservative treatments such as dietary modifications, topical medications, and rubber band ligation are typically recommended for hemorrhoidectomy. Additionally, patients with thrombosed hemorrhoids, large external hemorrhoids, or internal hemorrhoids that have prolapsed outside the anus may also benefit from hemorrhoidectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if hemorrhoidectomy is the best course of action for their individual case.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and discomfort.
  2. Patient may try conservative treatment options such as dietary changes, topical medications, and sitz baths.
  3. If conservative treatments are ineffective, patient may be referred to a colorectal surgeon for evaluation and consideration of surgical options.

After hemorrhoidectomy:

  1. Patient undergoes preoperative evaluation and preparation for surgery, which may include blood tests, imaging studies, and discussion of anesthesia options.
  2. Patient undergoes hemorrhoidectomy surgery, which can be performed using different techniques such as stapled hemorrhoidectomy or transanal hemorrhoidal dearterialization.
  3. After surgery, patient may experience postoperative pain, swelling, and discomfort, which can be managed with pain medications and sitz baths.
  4. Patient is discharged from the hospital and instructed on postoperative care, including wound care, diet modifications, and activity restrictions.
  5. Patient follows up with the surgeon for postoperative check-ups and monitoring of healing and recovery.
  6. Over time, patient should experience improvement in symptoms and resolution of hemorrhoids.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with hemorrhoidectomy surgery?
  2. How long is the recovery period after hemorrhoidectomy surgery?
  3. Will I need to take any special precautions or follow a specific diet after the surgery?
  4. What type of anesthesia will be used during the surgery?
  5. How long will the surgery take and how many days will I need to stay in the hospital?
  6. What is the success rate of hemorrhoidectomy surgery in terms of relieving symptoms and preventing recurrence?
  7. Are there any alternative treatments to consider besides hemorrhoidectomy?
  8. What can I do to help prevent hemorrhoids from returning after surgery?
  9. Will I need to make any lifestyle changes or modifications to prevent future hemorrhoid issues?
  10. How soon after surgery can I expect to resume normal activities and exercise?

Reference

Authors: Xu L, Chen H, Gu Y. Journal: Surg Laparosc Endosc Percutan Tech. 2019 Apr;29(2):75-81. doi: 10.1097/SLE.0000000000000612. PMID: 30540639