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New Hemorrhoid Therapy Comes With Risk

'Stapling' boosts odds of recurrence compared to conventional surgery, study finds

FRIDAY, Oct. 20, 2006 (HealthDay News) -- Hemorrhoid stapling is a relatively new and increasingly utilized form of treatment, but a new study says that patients who choose this method have a higher risk of recurrence and prolapse (protrusion outside the anus) than those who have conventional hemorrhoid surgery.

Stapling, which was introduced in the late 1990s, does not directly remove hemorrhoids, but treats them by inhibiting blood flow to the tissue. Some studies have concluded that patients treated with this approach have less pain and heal faster than those who have conventional hemorrhoid surgery.

Researchers reviewed seven clinical studies involving 537 patients. Of the 269 patients who had stapling, 23 suffered recurrent hemorrhoids in the long term, compared with four of the 268 patients who had their hemorrhoids surgically removed.

Patients who had stapling were also much more likely to suffer prolapse. Stapling was better than surgery in terms of less pain, itching or bowel movement urgency.

"If surgeons are to offer this novel technique to their patients, there should be an informed discussion of the risks," lead investigator Dr. Shiva Jayaraman Colquhoun, a resident in general surgery at the University of Western Ontario in London, Canada, said in a prepared statement.

"Proponents of this procedure argue it provides similar results to the open procedure with less pain, less disability and more rapid return to work. This paper states that the decreased pain and disability may entail increased risk of recurrence. As the authors noted, patients must be advised of this increased risk," Dr. Joshua Katz, of Montgomery Colorectal Surgery in Rockville, Md., said in a prepared statement.

Katz, who was not involved in the study, added that the increased risk is clinically acceptable.

The findings were published in the current issue of The Cochrane Library journal.

More information

The American Academy of Family Physicians has more about hemorrhoids.

SOURCE: Center for the Advancement of Health, news release, Oct. 17, 2006
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