The 5-year cumulative recurrence rate between group 1 (9% (95% CI, 4%–13%)) and group 2 (12% (95% CI, 7%–17%)) did not differ significantly ( p = 0.137), and the difference was within the noninferiority margin (absolute difference, –3.33% (95% CI, –10.00% to 3.55%)). Postoperative rectal stenosis did not develop in patients in group 1, although it occurred in 8 patients (5%) in group 2 ( p = 0.004). Anal continence significantly worsened after both procedures, but the difference between preoperative and postoperative continence scores was higher for group 2 than for group 1. Fewer patients in group 1 experienced postoperative urgency compared with those in group 2 ( p = 0.001). The visual analog scores in group 1 were less than those in group 2 ( p < 0.001). Secondary outcomes included incidence and severity of postoperative pain, fecal urgency, anal continence, and the frequency of specific complications, including anorectal stenosis and rectovaginal fistula. The primary outcome was the rate of recurrent prolapse at a median follow-up period of 5 years with a predefined noninferiority margin of 3.75%. Three hundred patients were randomly assigned to undergo either partial stapled hemorrhoidopexy (group 1, n = 150) or circumferential stapled hemorrhoidopexy (group 2, n = 150). Patients with grade III/IV hemorrhoids between August 2011 and November 2013 were included. The study was conducted at a single academic center. This was a parallel group, randomized, noninferiority clinical trial. ![]() The purpose of this study was to compare the long-term clinical efficacy and safety of partial stapled hemorrhoidopexy with circumferential stapled hemorrhoidopexy. Long-term outcomes and efficacy of partial stapled hemorrhoidopexy are not known. ![]() The work cannot be changed in any way or used commercially without permission from the journal. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The study design and article writing were not developed in collaboration with Touchstone.Ĭorrespondence: Dong-Lin Ren, M.D., Department of Coloproctology, The Sixth Affiliated Hospital of Sun Yat-sen University, 26 Yuancun Erheng Rd, Guangzhou 510655, China. The cost of stapler equipment and hospital stay were paid by the patients themselves. Labor costs for follow-up staff were supported by these 3 grants. Dr Lin is supported by the National Key Clinical Discipline Medical Scientific Research Foundation of Guangdong Province, China (grant A2015180), the National Natural Science Foundation of China (grant 81603628), and Sun Yat-Sen University Clinical Research 5010 Program (grant 2017017).
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