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Hemorrhoids: Surgery Beats Stapling

Recurrence Greater With Stapling, Review Shows
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WebMD Health News
Reviewed by Louise Chang, MD

Oct. 20, 2006 - An increasingly popular, nonsurgical treatment for hemorrhoids is not as effective in the long run as traditional surgery, a review of the research shows.

Once known as piles, hemorrhoids are one of the most common and least talked about medical complaints. About half of all Americans get them at some point.

Surgical removal was once the only option for large hemorrhoids that could not be adequately managed with topical therapies, but newer treatment options include rubber bands and staples that choke off their blood supply.

A review of the research, published last year, suggested surgery is a better long-term option for severe hemorrhoids than the banding procedure, known as rubber band ligation.

Now, a separate study shows the same to be true for hemorrhoid stapling.

Both research reviews were sponsored by The Cochrane Collaboration, an international, non-profit group that provides independent assessments of current medical practices.

The new findings were published in the latest issue of The Cochrane Library.

More Recurrences With Stapling

Hemorrhoid stapling has been growing in popularity since its introduction in the U.S. in the late 1990s, largely because it is viewed as a far less painful alternative to surgery.

Early studies found stapling to be as effective as surgery, but colon and rectal surgeon David Thompson, MD, FACRC, says this is not his experience among patients with severe hemorrhoids.

The University of Texas Medical School associate professor of surgery tells WebMD he does not consider stapling an appropriate treatment for patients with very painful internal and external hemorrhoids.

"I have seen many cases where patients with these severe hemorrhoids end up coming to us after having stapling because they are still having trouble," he says.

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