Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis
Abstract Objectives Hemorrhoids, a common anorectal condition, can be managed through surgical or conservative treatments. The aim of this meta-analysis is to compare the efficacy and safety of surgical and conservative treatments for hemorrhoids. Methods A systematic search was conducted from of Pu...
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2025-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-025-04089-2 |
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| author | Longfang Quan Xuelian Bai Fang Cheng Jin Chen Hangkun Ma Pengfei Wang Ling Yao Shaosheng Bei Xiaoqiang Jia |
| author_facet | Longfang Quan Xuelian Bai Fang Cheng Jin Chen Hangkun Ma Pengfei Wang Ling Yao Shaosheng Bei Xiaoqiang Jia |
| author_sort | Longfang Quan |
| collection | DOAJ |
| description | Abstract Objectives Hemorrhoids, a common anorectal condition, can be managed through surgical or conservative treatments. The aim of this meta-analysis is to compare the efficacy and safety of surgical and conservative treatments for hemorrhoids. Methods A systematic search was conducted from of PubMed, Embase, the Cochrane Library, and Web of Science from their inception to September 25, 2024. Eligible studies compared surgical treatments with non-invasive conservative treatments in hemorrhoids. Statistical analyses included pooled odds ratios (ORs) and mean differences (MDs)/standard mean differences (SMDs) with 95% confidence intervals (CIs). Results Seven studies, including 760 patients, were analyzed. Surgery achieved higher rates of complete symptom resolution than conservative therapy (OR = 2.96, 95% CI: 1.66–5.28, p < 0.001). Overall pain scores favored surgery (SMD = -0.93, 95% CI: 1.73 to -0.13, p = 0.02). Subgroup analysis showed clear superiority within four days (SMD = -1.26, 95% CI -1.84 to -0.68) but parity beyond ten days (SMD = 0.00, 95% CI -0.44 to 0.44; p = 0.99). Comparable patterns were observed in pregnant women with thrombosed external hemorrhoids. Rates of postoperative bleeding (OR: 1.09; 95% CI: 0.42 to 2.82, p = 0.86; I2 = 41%, p = 0.15) and urinary retention (OR: 1.75; 95% CI: 0.30 to 10.31, p = 0.54; I2 = 45%, p = 0.18) did not differ significantly between groups. Surgical-specific adverse events were infrequent (incontinence 3%, persistent pain 5%, watery discharge 6%). Surgery shortened recovery in pregnant thrombosed cases by approximately seven days (MD: -6.80; 95% CI: -7.64 to -5.96, p < 0.001; I2 = 55%, p = 0.14) and reduced overall recurrence (95% CI: 0.10 to 0.37, p < 0.001; I2 = 0%, p = 0.97). Conclusion Surgical treatments provide superior symptom relief, faster recovery, and lower recurrence but with some specific post-treatment complications, while conservative treatments are safer and less invasive but with provides slower symptom relief and higher recurrence rates. Individualized treatment should consider symptom severity, patient preferences, and risk tolerance. |
| format | Article |
| id | doaj-art-13b669bce9ce409ea3c063f9a4bad7c0 |
| institution | DOAJ |
| issn | 1471-230X |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj-art-13b669bce9ce409ea3c063f9a4bad7c02025-08-20T03:03:28ZengBMCBMC Gastroenterology1471-230X2025-07-0125111010.1186/s12876-025-04089-2Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysisLongfang Quan0Xuelian Bai1Fang Cheng2Jin Chen3Hangkun Ma4Pengfei Wang5Ling Yao6Shaosheng Bei7Xiaoqiang Jia8Department of Anorectal, Xiyuan Hospital of China Academy of Traditional Chinese MedicineDepartment of Management, Xiyuan Hospital of China Academy of Traditional Chinese Medicine 100091Department of Anorectal, Xiyuan Hospital of China Academy of Traditional Chinese MedicineDepartment of Management, Xiyuan Hospital of China Academy of Traditional Chinese Medicine 100091Department of Emergency, Xiyuan Hospital of China Academy of Traditional Chinese MedicineDepartment of Traditional Chinese Medicine, Fuzhou University Affiliated Provincial HospitalDepartment of Anorectal, Guang’anmen Hospital, China Academy of Chinese Medical SciencesDepartment of Anorectal, Xiyuan Hospital of China Academy of Traditional Chinese MedicineDepartment of Anorectal, Xiyuan Hospital of China Academy of Traditional Chinese MedicineAbstract Objectives Hemorrhoids, a common anorectal condition, can be managed through surgical or conservative treatments. The aim of this meta-analysis is to compare the efficacy and safety of surgical and conservative treatments for hemorrhoids. Methods A systematic search was conducted from of PubMed, Embase, the Cochrane Library, and Web of Science from their inception to September 25, 2024. Eligible studies compared surgical treatments with non-invasive conservative treatments in hemorrhoids. Statistical analyses included pooled odds ratios (ORs) and mean differences (MDs)/standard mean differences (SMDs) with 95% confidence intervals (CIs). Results Seven studies, including 760 patients, were analyzed. Surgery achieved higher rates of complete symptom resolution than conservative therapy (OR = 2.96, 95% CI: 1.66–5.28, p < 0.001). Overall pain scores favored surgery (SMD = -0.93, 95% CI: 1.73 to -0.13, p = 0.02). Subgroup analysis showed clear superiority within four days (SMD = -1.26, 95% CI -1.84 to -0.68) but parity beyond ten days (SMD = 0.00, 95% CI -0.44 to 0.44; p = 0.99). Comparable patterns were observed in pregnant women with thrombosed external hemorrhoids. Rates of postoperative bleeding (OR: 1.09; 95% CI: 0.42 to 2.82, p = 0.86; I2 = 41%, p = 0.15) and urinary retention (OR: 1.75; 95% CI: 0.30 to 10.31, p = 0.54; I2 = 45%, p = 0.18) did not differ significantly between groups. Surgical-specific adverse events were infrequent (incontinence 3%, persistent pain 5%, watery discharge 6%). Surgery shortened recovery in pregnant thrombosed cases by approximately seven days (MD: -6.80; 95% CI: -7.64 to -5.96, p < 0.001; I2 = 55%, p = 0.14) and reduced overall recurrence (95% CI: 0.10 to 0.37, p < 0.001; I2 = 0%, p = 0.97). Conclusion Surgical treatments provide superior symptom relief, faster recovery, and lower recurrence but with some specific post-treatment complications, while conservative treatments are safer and less invasive but with provides slower symptom relief and higher recurrence rates. Individualized treatment should consider symptom severity, patient preferences, and risk tolerance.https://doi.org/10.1186/s12876-025-04089-2HemorrhoidsSurgical treatmentConservative treatmentMeta-Analysis |
| spellingShingle | Longfang Quan Xuelian Bai Fang Cheng Jin Chen Hangkun Ma Pengfei Wang Ling Yao Shaosheng Bei Xiaoqiang Jia Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis BMC Gastroenterology Hemorrhoids Surgical treatment Conservative treatment Meta-Analysis |
| title | Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis |
| title_full | Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis |
| title_fullStr | Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis |
| title_full_unstemmed | Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis |
| title_short | Comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids: a meta-analysis |
| title_sort | comparison of efficacy and safety between surgical and conservative treatments for hemorrhoids a meta analysis |
| topic | Hemorrhoids Surgical treatment Conservative treatment Meta-Analysis |
| url | https://doi.org/10.1186/s12876-025-04089-2 |
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