Few areas of coloproctology attract as much attention or inspire so much heated debate than that of the treatment of hemorrhoids. Opinion varies widely and is frequently based on personal preference rather than a critical analysis of the literature. In this chapter an extensive review of the current literature on stapled hemorrhoidopexy and STARR is presented together with an overview of the current evidence level and grade of recommendation for both procedures. The reader is invited to assimilate the information provided and to come to an independent opinion on the relative merits of PPH and STARR, based on the best available scientific evidence.
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