A Meta-analysis On Short And Long Term Efficacy And Safety Of Procedure For Prolapse And Hemorrhoids

Objective:To Systematic review and meta-analysis of short and long term efficacy and safety of procedure for prolapse and hemorrhoids.Methods:Electronic databases including Cochrane Library, PubMed、OVIID、SpringerLinker、ScinceDirect、EBSCO、 CNKI、VIP、WanFang Data and CBM were searched.The date of search was between January2000and January2013.Randomized controlled trials(RCTs) were indentifieds studying association of Compare PPH and Milligan-Mogan(MMH) treatment.Study selection and meta-analysis were conducted according to the Cochrane Handbook for RevMan5.1software.Results:The trials involving1343patients were included.The results of meta-analysis indicated:compared with MMH, PPH operative time (OR=-11.05,95%CI:-15.15--6.95, P<0.01), duration of hospitalization(OR=3.07,95%CI:-4.46—1.69, P<0.01) and return to normal activity time(OR=-7.17,95%CI:-9.13--5.20, P<0.01) was short,postoperative pain light (OR=-3.13,95%CI:-4.38-1.88,P<0.01),but the high cost of treatment (OR=2534.2,95%CI:509.0-4559.4, P=0.01).Long-term efficacy,PPH was higher patient satisfaction (OR=2.21,95%CI:1.03-4.75,P=0.04),but the recurrence rate of prolapse(OR=3.75,95%CI:1.75-8.06,.P<0.01)and reoperation rate (OR=7.90,95%C7:1.78-35.03, P<0.01)higher.The incidence of anal stenosis and anal incontinence postoperative were higher than MMH(.P>0.05). the difference of post operative anal stenosis and anal incontinence and residual skin tag rate were not statistically significant(all P>0.05).Conclusions:PPH surgery can be used as replacement therapy of MMH for Ⅲ-Ⅳ°prolapsed hemorrhoids. But we should inform patients of prolapse recurrence and reoperation risk of PPH in the long term.