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Comparison of the early results of transanal hemorrhoidal dearterialization and hemorrhoidectomy using an ultrasonic scalpel

Surgery Today volume 45, pages 175–180 (2015)Cite this article

Abstract

Purpose

Doppler-guided transanal hemorrhoidal dearterialization and mucopexy (THD surgery) is a new approach for treating hemorrhoids. The early results of the procedure are presented and compared with those of hemorrhoidectomy using an ultrasonic scalpel (US surgery).

Methods

Thirty-six patients with grade III hemorrhoids underwent the THD surgery and were compared with a cohort of 30 patients with grade III or IV hemorrhoids who were assigned to US surgery in a previous randomized trial.

Results

The pain scores were significantly lower in the THD patients on days 6 and 7 after the operation. The number of analgesic tablets consumed during the first postoperative week in the THD patients was significantly lower than that in the US patients. The blood loss was significantly greater in the THD patients. The hospital stay and length of time until the first defecation after surgery were both significantly shorter in the THD patients. The postoperative complications were comparable between the two groups of patients.

Conclusion

The THD surgery was as effective as the US surgery for the treatment of hemorrhoids in the short term. THD surgery might be a preferred treatment because it is associated with a similar complication rate and short-term results, but results in lower postoperative pain and analgesic requirements compared with the US surgery.

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Acknowledgments

The authors thank Ms. Mariko Kawana and Ms. Yuka Kobori (pharmacists) for evaluating the pain score and analgesic requirements, and Dr. Yuko Tsunoda for providing assistance with the statistical analyses.

Conflict of interest

Akira Tsunoda and his co-authors have no conflict of interest to declare.

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Affiliations

  1. Department of Surgery, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba, 296-8602, Japan

    Akira Tsunoda, Yoshiyuki Kiyasu, Wataru Fujii & Nobuyasu Kano

Authors
  1. Akira Tsunoda
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  2. Yoshiyuki Kiyasu
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  3. Wataru Fujii
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  4. Nobuyasu Kano
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Correspondence to Akira Tsunoda.

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Tsunoda, A., Kiyasu, Y., Fujii, W. et al. Comparison of the early results of transanal hemorrhoidal dearterialization and hemorrhoidectomy using an ultrasonic scalpel. Surg Today 45, 175–180 (2015). https://doi.org/10.1007/s00595-014-0885-5

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  • DOI: https://doi.org/10.1007/s00595-014-0885-5

Keywords

  • Hemorrhoids
  • Prolapse
  • Doppler-guided transanal hemorrhoid dearterialization and mucopexy
  • Hemorrhoidectomy using an ultrasonic scalpel