Techniques in Coloproctology

, Volume 21, Issue 9, pp 737–743 | Cite as

A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique

  • A. L. H. Leung
  • T. P. P. Cheung
  • K. Tung
  • Y. P. Tsang
  • H. Cheung
  • C. W. Lau
  • C. N. Tang
Original Article



Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD).


Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD. Patient demographics, perioperative data, postoperative pain scores, recurrence and patient satisfaction scores were evaluated. Patients with acute thrombosed hemorrhoids, external hemorrhoids only, or other concomitant anal diseases were excluded.


From January 2013 to December 2015, 80 patients were included in the study, 40 in each group. There were no significant differences between groups as regards demographic data, perioperative data and postoperative pain scores. The median symptom scores for bleeding and prolapse were significantly lower in the TST group at 1 year (bleeding 1 vs. 2, p = 0.001; prolapse 1 vs. 2, p = 0.025). There was significantly less recurrence requiring reintervention in the TST group (4/40 vs. 17/40, p = 0.001). Satisfaction was significantly greater after TST. The median satisfaction scores after TST and THD were 4 and 3 (on a scale of 1–4; 4 = excellent satisfaction) (p < 0.00001), respectively.


Both THD and TST are safe, and they appear to have similar short-term outcomes; however, TST is associated with better improvement in symptoms, lower recurrence rates and greater patient satisfaction.


Hemorrhoids Hemorrhoidectomy Transanal hemorrhoidal dearterialization Circular stapled hemorrhoidopexy Partial stapled hemorrhoidopexy Tissue-selecting technique 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Hong Kong East Cluster Research Ethics Committee of the Hospital Authority.

Informed consent

Informed consent was obtained from every patient.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • A. L. H. Leung
    • 1
  • T. P. P. Cheung
    • 1
  • K. Tung
    • 1
  • Y. P. Tsang
    • 1
  • H. Cheung
    • 1
  • C. W. Lau
    • 1
  • C. N. Tang
    • 1
  1. 1.Department of SurgeryPamela Youde Nethersole Eastern HospitalChai WanPeople’s Republic of China

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