Abstract
Haemorrhoidal dearterialization with mucopexy is a minimally invasive method of treating haemorrhoidal disease which is effective for reducing the symptoms of haemorrhoids and improving quality of life. Moreover, it has the obvious advantages of preservation of the anatomy and physiology of the anal canal, absence of external wounds, better tolerance, and a less painful postoperative period, especially compared with haemorrhoidectomy, but also probably compared with stapled haemorrhoidopexy. It is therefore usually provided on a day surgery basis and scores better in terms of general activity and ability to return to social and/or work activities. The procedure is also safe, with low postoperative morbidity and few complications, which are usually minor.
There is a probable higher long-term risk of recurrence of prolapse and/or bleeding after haemorrhoidal dearterialization with mucopexy, particularly in comparison with haemorrhoidectomy, but it is not a real problem in a time when patients often prefer a risk-free procedure and a short-term benefit to a potential long-term disadvantage.
If you don’t like the way surgery is practised today, just wait a while – it will change.
(Campbell 2013)
References
Atallah S, Maharaja GK, Martin-Perez B, Burke JP, Albert MR, Larach SW (2016) Transanal hemorrhoidal dearterialization (THD): a safe procedure for the anticoagulated patient? Tech Coloproctol 20:461–466
Bursics A, Morvay K, Kupcsulik P, Flautner L (2004) Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study. Int J Colorectal Dis 19:176–180
Campbell B (2013) Surgical aphorisms. Br J Surg 100:1673–1674
Cavazzoni E, Bugiantella W, Graziosi L, Silvia Franceschini M, Cantarella F, Rosati E, Donini A (2013) Emergency transanal haemorrhoidal Doppler guided dearterialization for acute and persistent haemorrhoidal bleeding. Colorectal Dis 15:e89–e92
De Nardi P, Capretti G, Corsaro A, Staudacher C (2014) A prospective, randomized trial comparing the short- and long-term results of doppler-guided transanal hemorrhoid dearterialization with mucopexy versus excision hemorrhoidectomy for grade III hemorrhoids. Dis Colon Rectum 57:348–353
Denoya PI, Fakhoury M, Chang K, Fakhoury J, Bergamaschi R (2013) Dearterialization with mucopexy versus haemorrhoidectomy for grade III or IV haemorrhoids: short-term results of a double-blind randomized controlled trial. Colorectal Dis 15:1281–1288
Denoya P, Tam J, Bergamaschi R (2014) Hemorrhoidal dearterialization with mucopexy versus hemorrhoidectomy: 3-year follow-up assessment of a randomized controlled trial. Tech Coloproctol 18:1081–1085
Elmér SE, Nygren JO, Lenander CE (2013) A randomized trial of transanal hemorrhoidal dearterialization with anopexy compared with open hemorrhoidectomy in the treatment of hemorrhoids. Dis Colon Rectum 56:484–490
Elshazly WG, Gazal AE, Madbouly K, Hussen A (2015) Ligation anopexy versus hemorrhoidectomy in the treatment of second- and third-degree hemorrhoids. Tech Coloproctol 19:29–34
Festen S, van Hoogstraten MJ, van Geloven AA, Gerhards MF (2009) Treatment of grade III and IV haemorrhoidal disease with PPH or THD. A randomized trial on postoperative complications and short-term results. Int J Colorectal Dis 24:1401–1405
Giordano P, Nastro P, Davies A, Gravante G (2011) Prospective evaluation of stapled haemorrhoidopexy versus transanal haemorrhoidal dearterialisation for stage II and III haemorrhoids: three-year outcomes. Tech Coloproctol 15:67–73
Gravié JF (2014) Hemorrhoidal arterial ligation with mucopexy: a risk-free technique? J Visc Surg 151:421–422
Herold A (2012) Comment on Infantino et al. Colorectal Dis 14:212–213
Infantino A, Altomare DF, Bottini C, Bonanno M, Mancini S, THD Group of the SICCR (Italian Society of Colorectal Surgery), Yalti T, Giamundo P, Hoch J, El Gaddal A, Pagano C (2012) Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. Colorectal Dis 14:205–211
Karin E, Avital S, Dotan I, Skornick Y, Greenberg R (2012) Doppler-guided haemorrhoidal artery ligation in patients with Crohn’s disease. Colorectal Dis 14:111–114
Khafagy W, El Nakeeb A, Fouda E, Omar W, Elhak NG, Farid M, Elshobaky M (2009) Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology 56:1010–1015
Lehur PA, Didnée AS, Faucheron JL, Meurette G, Zerbib P, Siproudhis L, Vinson-Bonnet B, Dubois A, Casa C, Hardouin JB, Durand-Zaleski I, LigaLongo Study Group (2016) Cost-effectiveness of new surgical treatments for hemorrhoidal disease: a multicentre randomized controlled trial comparing transanal Doppler-guided hemorrhoidal artery ligation with mucopexy and circular stapled hemorrhoidopexy. Ann Surg 264:710–716
Pescatori M, Gagliardi G (2008) Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures. Tech Coloproctol 12:7–19
Ratto C, Parello A, Donisi L, Litta F, Doglietto GB (2011) Anorectal physiology is not changed following transanal haemorrhoidal dearterialization for haemorrhoidal disease: clinical, manometric and endosonographic features. Colorectal Dis 13:e243–e245
Simillis C, Thoukididou SN, Slesser AA, Rasheed S, Tan E, Tekkis PP (2015) Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg 102:1603–1618
Zampieri N, Castellani R, Andreoli R, Geccherle A (2012) Long-term results and quality of life in patients treated with hemorrhoidectomy using two different techniques: Ligasure versus transanal hemorrhoidal dearterialization. Am J Surg 204:684–688
Conflict of Interest
NF, AB, EC, JDZ, FP: none.
VdP, EP, PB: payment for travel to surgical meeting
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de Parades, V. et al. (2017). Main Advantages of Dearterialization of Haemorrhoids and Mucopexy. In: Ratto, C., Parello, A., Litta, F. (eds) Hemorrhoids. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-51989-0_39-1
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DOI: https://doi.org/10.1007/978-3-319-51989-0_39-1
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