Annals of Coloproctology

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Original Article

Transanal Hemorrhoidal Dearterialization With Doppler Arterial Identification Versus Classic Hemorrhoidectomy: A Retrospective Analysis of 270 Patients: Vincenzo Consalvo, Francesca D’Auria, Vincenzo Salsano; Ann Coloproctol. 2019;35(3):118-122. Published online May 31, 2019; DOI: https://doi.org/10.3393/ac.2017.09.04

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Purpose
Despite the minimally invasive nature of transanal hemorrhoidal dearterialization (THD) with Doppler arterial identification procedures, hemorrhoidectomy is still considered the gold standard procedure for hemorrhoidal disease. However, the classical techniques of hemorrhoidectomy have a high rate of postoperative complications. The main purpose of this study is to demonstrate the efficacy and complications of these techniques used for grades II and III hemorrhoids.
Methods
A retrospective (case-control) study was carried out from January 2009 to May 2014, and all patients undergoing surgical procedures for hemorrhoidal disease in two French clinics were considered. Application of inclusion and exclusion criteria identified 270 eligible patients (163 undergoing Doppler THD and 107 treated with Milligan Morgan hemorrhoidectomy). Statistical analysis was calculated considering immediate postoperative complications, functional results, chronic complications, and recurrences.
Results
Analysis of primary outcomes showed a significant difference between the 2 groups concerning postoperative pain, which had a lower rate in THD (P = 0.0001) and in postoperative bleeding (P = 0.02) than hemorrhoidectomy. However, long-term follow-up at three years showed a superior rate of recurrence in the THD group (P = 0.009).
Conclusion
The THD technique is a safe and effective procedure for grades II and III hemorrhoids, has lower rates of post-operative pain and bleeding, and allows faster hospital discharge; however, it also shows a higher rate of recurrence at three years of follow-up.

Citations

Citations to this article as recorded by

Milligan–Morgan hemorrhoidectomy combined with rubber band ligation and polidocanol foam sclerotherapy for the management of grade III/IV hemorrhoids: a retrospective study
Qing Long, Yong Wen, Jun Li
BMC Gastroenterology.2025;[Epub] CrossRef
Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Vessel-Sealing Device Hemorrhoidectomy for Grade III to IV Hemorrhoids: Long-term Outcomes From the THDLIGA Randomized Controlled Trial
Loris Trenti, Sebastiano Biondo, Eloy Espin-Basany, Oriana Barrios, Jose L. Sanchez-Garcia, • Aitor Landaluce-Olavarria, Elena Bermejo-Marcos, • Maria T. Garcia-Martinez, David Alias Jimenez, Fernando Jimenez, Adolfo Alonso, Maria B. Manso, Esther Kreisle
Diseases of the Colon & Rectum.2023; 66(8): e818. CrossRef
Excisional Hemorrhoidectomy Versus Dearterialization With Mucopexy for the Treatment of Grade III Hemorrhoidal Disease: The EMODART3 Multicenter Study
Antonio Giuliani, Lucia Romano, Stefano Necozione, Vincenza Cofini, Giada Di Donato, Mario Schietroma, Francesco Carlei
Diseases of the Colon & Rectum.2023; 66(12): e1254. CrossRef
CLINICAL AND MORPHOLOGICAL EVALUATION OF THE EFFECTIVENESS OF USING RADIO WAVE AND HIGH-FREQUENCY ELECTROSURGERY TECHNOLOGIES FOR THE TREATMENT OF COMBINED ANORECTAL DISEASES
V. V. Balytskyy, M. P. Zakharash, O. G. Kuryk
World of Medicine and Biology.2022; 18(80): 19. CrossRef
Linear Pinched Hemorrhoidectomy: A Retrospective Observational Study (An Innovative, Simplified Hemorrhoidectomy)
Akiharu Kurihara, Yu Yoshino, Yu Sakai, Yasuyuki Miura, Satoru Kagami, Tomoaki Kaneko, Mitsunori Ushigome, Hiroyuki Shiokawa, Hironori Kaneko, Kimihiko Funahashi
Journal of the Anus, Rectum and Colon.2021; 5(3): 261. CrossRef
Haemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study
P. V. Tsarkov, M. A. Popovtsev, Yu. S. Medkova, A. V. Alekberzade, N. N. Krylov
Sechenov Medical Journal.2021; 12(3): 47. CrossRef
Hemorrhoidal artery ligation without Doppler navigation in surgical treatment of hemorrhoidal disease
M.A. Popovtsev, A.V. Alekberzade, N.N. Krylov
Khirurgiya. Zhurnal im. N.I. Pirogova.2021; (12): 49. CrossRef

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