Flavonoids and post haemorrhoidectomy recovery: a systematic review and meta‐analysis

Author:

Pitesa Renato1ORCID,Yuen Wai Yan (Rachel)1,Hill Andrew G.12ORCID

Affiliation:

1. Department of General Surgery Middlemore Hospital Auckland New Zealand

2. Department of Surgery, South Auckland Clinical Campus The University of Auckland Auckland New Zealand

Abstract

AbstractBackgroundHaemorrhoidectomy is the gold standard for definitive treatment of high‐grade symptomatic haemorrhoids but is often associated with substantial pain. This systematic review aims to explore the potential of flavonoids in alleviating the postoperative symptom burden following excisional haemorrhoidectomy.MethodsA systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines (PROSPERO CRD42023472711). Randomized controlled trials (RCTs) published PubMed, MEDLINE, Embase, and Scopus from inception to 1st December 2023 were retrieved. The primary outcome investigated was post‐operative pain. Meta‐analysis was performed using Review Manager version 5.4.1.ResultsTen articles with 775 patients were included. The meta‐analysis identified statistically significant decreases in post‐operative pain in favour of the flavonoid groups (Standardized Mean Difference −0.66 [95% confidence intervals (CI) −0.82, −0.52]; P < 0.00001), and bleeding (Odds Ratio 0.13 [95% CI 0.09, 0.19]; P < 0.00001).ConclusionFlavonoids show promise as a means of reducing pain associated with excisional haemorrhoidectomy. Further research is required to investigate topical routes of administration and standardize regimes.

Publisher

Wiley

Reference37 articles.

1. Epidemiology of haemorrhoids and publicly funded excisional haemorrhoidectomies in New Zealand (2007‐2016): a population‐based cross‐sectional study;Xia W;Colorectal. Dis. Off. J. Assoc. Coloproctol. G B Irel.,2021

2. Treatment of hemorrhoids: a survey of surgical practice in Australia and New Zealand;Fowler GE;World J. Clin. Cases,2019

3. Strategies to reduce post‐hemorrhoidectomy pain: a systematic review;Lohsiriwat V;Medicina (Mex).,2022

4. Topical analgesia following excisional haemorrhoidectomy: a systematic review and meta‐analysis of randomised controlled trials;Xia W;Int. J. Colorectal Dis.,2020

5. Evidence‐based management of pain after excisional haemorrhoidectomy surgery: a PROSPECT review update;Sammour T;World J. Surg.,2017

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