Stapled or Excisional Hemorrhoidectomy for Severe Hemorrhoids?

Excisional hemorrhoidectomy for advanced hemorrhoids is considered a painful procedure, which has led to development of alternative approaches. One of these is stapled hemorrhoidopexy, which involves excision of a rim of tissue above the internal hemorrhoids with re-anastomosis of the mucosa using staples. This operation is sometimes endorsed for being less painful than excisional hemorrhoidectomy.

In a randomized, controlled trial in the U.K., researchers compared outcomes with excisional hemorrhoidectomy versus stapled hemorrhoidopexy in 777 patients with grade 2, 3, or 4 hemorrhoids (22%, 63%, and 15%, respectively).

In the first few weeks after hemorrhoidectomy, quality of life was better in patients with the stapling procedure, but after…