Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK. The disease is therefore important both to patients and to health service commissioners. Debate remained as to which of these surgical procedures was the most clinically effective and cost-effective.

The eTHoS Trial was a multicentre UK trial which aimed to establish the effectiveness of stapled haemorrhoidpexy (SH) compared with traditional excisional haemorrhoidectomy (TH) for the management of grade II–IV haemorrhoids. The trial recruited 777 participants from 29 UK centres between 13 January 2011 and 1 August 2014.

The eTHoS trial showed that overall quality of life (the primary outcome) at 24 months post randomisation, favoured traditional excisional surgery. Additionally, less residual haemorrhoid symptoms and fewer recurrences and re-interventions were noted in the traditional excisional surgery group. 





Watson Angus J M, Hudson Jemma, Wood Jessica, Kilonzo Mary, Brown, Steven R , McDonald Alison, Norrie John, Bruhn Hanne, Cook Jonathan A, on behalf of the eTHoS study group; Comparison of stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease (eTHoS): a pragmatic, multicentre, randomised controlled trial; The Lancet Vol 388 November 12, 2016;

Watson Angus JM, Cook Jonathan, Hudson Jemma, Kilonzo Mary, Wood Jessica, Bruhn Hanne, Brown Steven, Buckley Brian, Curran Finlay, Jayne David, Loudon Malcolm, Rajagopal Ramesh, McDonald Alison & Norrie John; A pragmatic multicentre randomised controlled trial comparing stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease: the eTHoS study; Health Technology Assessment Volume: 21, Issue: 70, December 2017;