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This commissioning statement refers to:
This commissioning statement does not refer to:
Referral for non-urgent assessment and treatment
Conservative management techniques include:
There is some evidence of longer term efficacy of conventional haemorrhoidectomy over stapled procedure.
Short term efficacy and cost effectiveness is similar.
Stapled haemorrhoidopexy for the treatment of haemorrhoids1
Technology appraisal guidance [TA128]Published date: 26 September 2007
Cochrane Library3 Stapled versus conventional surgery for hemorrhoids Kathleen J Lumb, Patrick H.D. Colquhoun, Richard Malthaner, Shiva Jayaraman First published: 18 October 2006
American Society of Colon and Rectal Surgeons5 Practice parameters for the management of hemorrhoids (revised 2010). Jama Surgery4
Long-term Outcomes of Stapled Hemorrhoidopexy vs Conventional Hemorrhoidectomy A Meta-analysis of Randomized Controlled Trials Pasquale Giordano, MD, FRCSEd, FRCS; Gianpiero Gravante, MD; Roberto Sorge, PhD; Lauren Ovens, MBChB, MRCS; Piero Nastro, MD, MRCS Arch Surg. 2009;144(3):266-272. doi:10.1001/archsurg.2008.591.
NICE Clinical Knowledge Summaries6