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Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids.

Method

One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation. Quality of life, anal symptoms, recurrence of hemorrhoids, and reoperation were assessed by means of a questionnaire and of a clinical examination at long-term follow-up (7.0 year average).

Results

At short-term follow-up, the median postoperative pain score was significantly lower in DG-THD group compared to SH group, (V.A.S 2 vs 6; t = 2.65, p < 0.01). The morbidity rate and the return to normal life and work were similar after the two procedures. At long-term follow-up, the incidence of piles was not statistically different between the two groups (DG-THD 10.0 %; SH 14.0 %). No differences were reported by patients in terms of satisfaction for surgery.

Conclusion

SH and DG-THD procedures do not show significantly different results with regard to the patients outcome. However, considering the lower p. o. pain, the DG-THD might be proposed as the first line treatment in third-degree hemorrhoids.

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Acknowledgments

The authors thank Maria Silvia Marottoli for her assistance in the translation.

Statement of Author Contribution

S. Leardi: substantial contributions to the conception and design of the work, analysis and interpretation of data for the work

B. Pessia, M. Mascio, F. Piccione, M.: acquisition data for the work

M. Schietroma: drafting the work

R. Pietroletti: revising the work critically for important intellectual content

Author information

Authors and Affiliations

  1. Surgery Unit–Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, L’Aquila, Italy

    S. Leardi, B. Pessia, M. Mascio, F. Piccione & M. Schietroma

  2. Department of Life, Health and Environmental Sciences MeSVA, University of L’Aquila, L’Aquila, Italy

    R. Pietroletti

  3. Dipartimento Scienze Cliniche Applicate e Biotecnologie, Ospedale Civile San Salvatore, Università degli Studi di L’Aquila, Edificio Delta 6, 67100, L’Aquila, Italy

    S. Leardi

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  1. S. Leardi
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  2. B. Pessia
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Correspondence to S. Leardi.

Additional information

R. Pietroletti from 2013 is the chief of the Colon-proctology Surgery Unit—Val Vibrata Hospital—Dept. of MeSVA, University of L’Aquila—Italy.

Appendix

Appendix

Questionnaire for patients who undergone surgery for third-degree hemorrhoids.

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Leardi, S., Pessia, B., Mascio, M. et al. Doppler-Guided Transanal Hemorrhoidal Dearterialization (DG-THD) Versus Stapled Hemorrhoidopexy (SH) in the Treatment of Third-Degree Hemorrhoids: Clinical Results at Short and Long-Term Follow-Up. J Gastrointest Surg 20, 1886–1890 (2016). https://doi.org/10.1007/s11605-016-3220-1

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