Twenty nine RCTs were included (n was reported as 1,079, sample size range was 11 to 125). None were double-blinded. Eight studies used blinded data collection, 12 described withdrawals and 22 described randomisation adequately. Fourteen studies were unsuitable for meta-analysis as they did not report standard deviations.
Electrothermal bipolar vessel sealing systems versus conventional haemostatic methods (26 RCTs, n=2,186):
Among RCTs suitable for meta-analysis, the intervention was associated with statistically significant reductions in operating time (normalised mean reduction 28%, 95% CI: 18%, 39%, p<0.0001; 15 RCTs), blood loss (mean reduction 43 mL, 95% CI: 14 mL, 73 mL, p=0.0021; five RCTs) and pain score (WMD 2.8 units, 95% CI: 1.5, 4.1, p<0.0001; four RCTs), with statistically significant heterogeneity for the outcomes of operating time (p<0.00001) and pain (p<0.0001).
There were significantly fewer complications in the intervention group (OR 0.66, 95% CI: 0.47,0.92, p=0.02; 22 RCTs). No statistically significant difference was found between the groups in length of hospital stay (nine RCTs). Among haemorrhoidectomy studies only, the normalised mean reduction in operating time was 46 per cent (95% CI: 29%, 62%, p<0.0001; six RCTs), with significant heterogeneity (p<0.00001). All but two of the 26 studies reported shorter operating times in the intervention group (p<0.0001).
Electrothermal bipolar vessel sealing systems versus ultrasonic energy (reported as five RCTs in the text):
No statistically significant difference in complication rate was found between the two groups. No other data were suitable for meta-analysis.
Other results were reported in the review.