[Meta-analysis of randomized controlled trials comparing procedure for prolapse and XXXX with Milligan-Morgan hemorrhoidectomy in the treatment of @entity6713 ].

@entity1 @entity322 @entity3549 @entity86 @entity158 @entity6713
OBJECTIVE: To compare the safety and efficacy of procedure for prolapse and @entity6713 (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of @entity6713 . METHODS: All the randomized controlled trials (RCT) comparing PPH with MMH in the treatment of @entity6713 published between January 1998 and January 2015 were retrieved from PubMed, Embase, Cochrane Library, CBM, CNKI, Wangfang, @entity3549 databases. Hand search was applied in Chinese Journal of Gastrointestinal Surgery, Chinese Journal of Coloproctology and Journal of Colorectal and Anal Surgery from the library of Chengdu University of Traditional Chinese Medicine. Associated reference documents in enrolled trials were reviewed. The methodological quality of enrolled trials was evaluated according to the Cochrane handbook for systematic reviews of interventions. Meta-analysis was performed using RevMan 5.3 software. RESULT: Sixteen RCTs recruiting 1411 @entity1 were identified. Among them, 702 @entity1 underwent PPH, and other 709 @entity1 MMH. Meta-analysis showed that as compared to MMH, PPH had shorter operating time(WMD=-12.34, 95% CI:-17.87 to -6.80, P=0.000], shorter hospital stay (WMD=-1.48, 95% CI: -1.81 to -1.14, P=0.000) and shorter time to recover normal activity (WMD=-14.11, 95% CI: -24.51 to -3.70, P=0.008). @entity1 in PPH group experienced less @entity158 at postoperative 24 h, postoperative 1 week and the first postoperative bowel movement (all P<0.01). PPH was more ascendant in terms of the requirement for analgesics(P<0.01). PPH group had higher ratio of wound-healing 2 weeks after surgery (RR=0.19, 95% CI: 0.07 to 0.51, P=0.001), lower ratio of @entity86 (RR=0.39, 95% CI: 0.15 to 0.99, P=0.050) and lower ratio of anal @entity322 (RR=0.62, 95% CI: 0.38 to 1.01, P=0.050), but higher ratio of recurrent disease after 1 year (RR=2.54, 95% CI: 1.21 to 5.31, P=0.010). No significant differences in ratios of @entity86 , urinary retention, and postoperative morbidity of complication were found(all P>0.05). Satisfaction degree of @entity1 in PPH group was better than that in MMH group (OR=2.36, 95% CI:1.36 to 4.07, P=0.002). CONCLUSION: Procedure for prolapse and @entity6713 offers some short-term benefits over Milligan-Morgan hemorrhoidectomy, but is associated with a higher rate of recurrent disease.
