Comparison Of Clinical Outcomes Between Tissue-selecting Therapy Stapler And The Procedure For Prolapse And Hemorrhoids For Severe Internal Hemorrhoids:A Meta-analysis

Objective:Comparison of TST and PPH on the treatment of moderate and severe internal hemorrhoids efficacy,feasibility and safety.Methodology:By searching CBM-disc,WANFANG DATA,CNKI,Pubmed,Embase,Cocharne and other Chinese and English databases,A randomized controlled trial was obtained,which was limited to 2007.01.01-2017.03.31.The effects of random effects model,fixed effect mode,sensitivity analysis and subgroup analysis were used.Review Manager 5.3,stata12.0 And other software on the treatment of TST and PPH moderate and severe internal hemorrhoids as well as the safety and feasibility of meta-analysis of indicators.Results:This article was screened,a total of seven RCT literature in line with the inclusion criteria,a total of 2058 patients,of which 1030 cases in the study group,the control group 1028 cases.Meta-analysis showed that there was no statistically significant difference between the two treatments(WMD =-0.74,95% CI[-3.00,1.52],P = 0.52),hospitalization time(WMD = 0.04,95% CI = [-0.20,0.28],P= 0.75)were not statistically significant;TST group had less intraoperative blood loss than PPH group(WMD =-1.41,95% CI = [-1.81(RR = 0.07,95% CI = [0.03,0.17],P <0.00001),and the difference was statistically significant.Selective hemorrhoid mucosal resection(TST)(RR = 0.11,95% CI = [0.05,0.23],P <0.00001),and postoperative anal bleeding(RR = 0.33,95% CI = [0.22,0.48],P <0.00001)(RR =0.30,95% CI = [0.17,0.53],P <0.0001),anastomotic stenosis(RR = 0.21,95% CI =[0.10,0.42],P <0.0001)and other complications Statistical significance.Conclusion:In general,TST and PPH are safe,viable and effective.Overall efficacy,length of stay,and considerable operative time.However,TST surgery in the control of anal bulge,urinary retention,postoperative anal bleeding,postoperative pain,anastomoticstenosis and other complications and control the amount of bleeding,hospital costs have obvious advantages.However,all of the seven literatures were selected for a shorter period of time,and their long-term treatment was still followed by prolonged follow-up and a large number of RCT case studies.