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Andrea Cariati, MD

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Every year nearly 40 000 hemorrhoidectomies are performed in Italy, France, and England, and nearly 320 000 hemorrhoidectomies are performed in the United States.¹ The difference in hospital costs between 1-day conventional and stapler hemorrhoidectomy is nearly 800 (US $1130) (the cost of the stapler). This means that if in a year all hemorrhoidectomies in the United States were performed using the stapler technique, the annual hospital bill would be 256 million (US $361 million) more expensive.

Moreover, randomized controlled trials report better results for conventional hemorrhoidectomy^2-3; stapled hemorrhoidectomy is a safe technique but carries a significantly higher incidence of recurrence and additional operations when compared with conventional hemorrhoidectomy.⁴ Conventional hemorrhoidectomy (Milligan Morgan or Ferguson techniques) can reduce hospital costs in the United States by 256 million and by nearly 32 million ($US 45 million) in Italy, France, and England. In my opinion, it is very important to avoid . . . [Full Text of this Article]

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