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Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials

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Abstract

Background

The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids.

Methods

Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random effects models.

Results

Four trials, including 316 patients, met the inclusion criteria. No statistically significant differences were noted in either total complications or postoperative bleeding, incontinence, recurrent prolapse, and urinary retention rate. Operative time was significantly longer for THDm with Doppler guidance than for THDm without Doppler guidance. Patients returned to normal activities faster after THDm than after OH. No statistically significant differences between THDm and OH were noted with regard to recurrence and reoperation rates.

Conclusions

Our meta-analysis shows that THDm and OH are equally effective and can be attempted for the management of hemorrhoids. However, for THDm with Doppler guidance, more instruments and a longer operative time are required. Future large-scale, high-quality, multicenter trials with long-term outcomes are needed to prove these results and determine whether Doppler guidance in THD is truly necessary or not.

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Authors and Affiliations

  1. Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People’s Republic of China

    L. Xu, G. Lin, Q. Ge, H. Qi & X. He

  2. Department of Gastrointestinal Endoscopy, Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China

    H. Chen

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  1. L. Xu
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  2. H. Chen
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  3. G. Lin
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  4. Q. Ge
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  5. H. Qi
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  6. X. He
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Correspondence to L. Xu.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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For this type of study formal consent is not required.

Additional information

Li Xu and Honglei Chen are co-first authors of this study.

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Xu, L., Chen, H., Lin, G. et al. Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials. Tech Coloproctol 20, 825–833 (2016). https://doi.org/10.1007/s10151-016-1551-2

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  • DOI: https://doi.org/10.1007/s10151-016-1551-2

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