SynthesisInternational journal of colorectal disease2021
An update on surgical treatment of hemorrhoidal disease: a systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Laser hemorrhoidoplasty versus LigaSure hemorrhoidectomy for grade II-IV hemorrhoidal disease: a systematic review and meta-analysis.BMC surgery · 2026Pooled it
- Tissue selecting therapy stapler minimally invasive surgery to treat severe hemorrhoids.BMC surgery · 2025Trial
- Comparison between stapled hemorrhoidopexy and harmonic scalpel hemorrhoidectomy in the management of third- and fourth-degree piles: a randomized clinical trial.Chirurgie (Heidelberg, Germany) · 2024Trial
- Tamponade dressing versus no dressing after haemorrhoidectomy: multicentre, randomized clinical trial.BJS open · 2022Trial
- Evaluation of short-term outcomes of Endoscopic Super-Hemorrhoidal Banding for mixed hemorrhoids with prolapsed internal hemorrhoids: a retrospective study.BMC surgery · 2026Article
- Article
- Modified Circular Hemorrhoidectomy for Stage IV Hemorrhoids With Terminal Prolapse: A Case Series.Cureus · 2025Article
- Clinical observation on prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation.World journal of gastrointestinal surgery · 2025Article
- Timing and Modality of Hemorrhoidal Prolapse Impact on Patients' Quality of Life.Journal of clinical medicine · 2024Article
- Bio-thermal response during laser haemorrhoidoplasty: an exclusive analytical and numerical approach for theoretical investigation.Lasers in medical science · 2024Article
- Laser hemorrhoidoplasty in the treatment of symptomatic hemorrhoids: a pilot Australian study.Annals of coloproctology · 2024Article
- Efficacy and Safety of Snap Needles in the Treatment of Postoperative Hemorrhoidal Pain: A Systematic Review and Meta-Analysis.Journal of pain research · 2024Article
- Article
- PROSPECT guideline for haemorrhoid surgery: A systematic review and procedure-specific postoperative pain management recommendations.European journal of anaesthesiology and intensive care · 2023Article
- Review
- Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: An Italian single-institution 5-year experience analysis and updated literature review.Frontiers in surgery · 2022Article
- Correlation Between Poor Defecation Habits and Postoperative Hemorrhoid Recurrence.Frontiers in surgery · 2022Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPathologic hemorrhoids are common among adults age 45-65. Hemorrhoids are characterized as internal or external, and grades 1-4 based on severity. The type and grade dictate treatment, with surgical treatment reserved for grades 3/4. The aim of this study is to compare clinical outcomes of various surgical treatments.
methodsA systematic review was conducted to identify randomized clinical trials that compare surgical treatments for grade 3/4 hemorrhoids. A Bayesian network meta-analysis was done using NetMetaXL and WinBUGS.
resultsA total of 26 studies with 3137 participants and 14 surgical treatments for grade 3/4 hemorrhoids were included. Pain was less in patients with techniques such as laser (OR 0.34, CI 0.01-6.51), infrared photocoagulation (OR 0.38, CI 0.02-5.61), and stapling (OR 0.48, CI 0.19-1.25), compared to open and closed hemorrhoidectomies. There was less recurrence with Starion (OR 0.01, CI 0.00-0.46) and harmonic scalpel (OR 0.00, CI 0.00-0.49), compared to infrared photocoagulation and transanal hemorrhoidal dearterialization. Fewer postoperative clinical complications were seen with infrared photocoagulation (OR 0.04, CI 0.00-2.54) and LigaSure (OR 0.16, CI 0.03-0.79), compared to suture ligation and open hemorrhoidectomy. With Doppler-guided (OR 0.26, CI 0.05-1.51) and stapled (OR 0.36, CI 0.15-0.84) techniques, patients return to work earlier when compared to open hemorrhoidectomy and laser.
conclusionThere are multiple favorable techniques without a clear "gold standard" based on current literature. Open discussion should be had between patients and physicians to guide individualized care.
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