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Group\u00a0I underwent SH and group\u00a0II underwent HSH. The mean age of group\u00a0I was 42.94\u00a0years and of group\u00a0II, 42.20\u00a0years. The mean time of the procedure was 24.42\u202fmin\u202f\u00b1\u20092.367 for SH and 31.48\u202fmin\u202f\u00b1\u20092.21 for HSH. Postoperative pain in group\u00a0I was lower than in group\u00a0II during the first 2\u00a0weeks, but there was persistent mild pain in most patients in group\u00a0I at the 2\u2011week follow-up. In group\u00a0II there was significant improvement in pain after 2\u00a0weeks, with higher patient satisfaction. Wound infection was detected in 3\u00a0(5%) patients in group\u00a0I and no patients in group\u00a0II (<jats:italic>p<\/jats:italic>\u202f=\u20090.077). Postoperative bleeding occurred in 4\u00a0(11.4%) patients in group\u00a0I in the form of spotting after defecation only during the first postoperative month; no bleeding was detected in group\u00a0II (<jats:italic>p<\/jats:italic>\u202f=\u20090.039). There were 3\u00a0(15%) cases of flatus incontinence but after taking a detailed history these were found to be cases of urgency to defecate rather than incontinence. There were 7\u00a0(20%) cases of recurrence at the 1\u2011year follow-up in group\u00a0I and 1\u00a0(2.9%) case in group\u00a0II (<jats:italic>p<\/jats:italic>\u202f=\u20090.024).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Compared with SH, HSH was safer, easier, and associated with a\u00a0lower incidence of recurrence after 1\u00a0year and with higher patient satisfaction.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00104-023-02010-9","type":"journal-article","created":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T12:01:41Z","timestamp":1703851301000},"page":"14-22","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison between stapled hemorrhoidopexy and harmonic scalpel hemorrhoidectomy in the management of third- and fourth-degree piles: a\u00a0randomized clinical trial","Vergleich zwischen Stapler-H\u00e4morrhoidopexie und H\u00e4morrhoidektomie mit dem harmonischen Skalpell bei der Behandlung vor dritt- und viertgradigen H\u00e4morrhoiden \u2013 eine randomisierte klinische Studie"],"prefix":"10.1007","volume":"95","author":[{"given":"Mohamed Ali Mohamed","family":"Nada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philobater Bahgat Adly","family":"Awad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew Morcos Azmy","family":"Kirollos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa Mohamed","family":"Abdelaziz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim Mohamed Saad","family":"Mohamed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerolos Bahgat Adly","family":"Awad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basma Hussein Abdelaziz","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,29]]},"reference":[{"issue":"17","key":"2010_CR1","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.2217\/cer-2020-0159","volume":"9","author":"P Sheikh","year":"2020","unstructured":"Sheikh\u00a0P, R\u00e9gnier\u00a0CH, Goron\u00a0F et\u00a0al (2020) The prevalence, characteristics and treatment of hemorrhoidal disease: results of an international web-based survey. 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