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

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• 作者：Akira Tsunoda (1)
  Yoshiyuki Kiyasu (1)
  Wataru Fujii (1)
  Nobuyasu Kano (1)
  
  1. Department of Surgery ; Kameda Medical Center ; 929 Higashicho ; Kamogawa ; Chiba ; 296-8602 ; Japan
  
• 关键词：Hemorrhoids ; Prolapse ; Doppler ; guided transanal hemorrhoid dearterialization and mucopexy ; Hemorrhoidectomy using an ultrasonic scalpel
• 刊名：Surgery Today
• 出版年：2015
• 出版时间：February 2015
• 年：2015
• 卷：45
• 期：2
• 页码：175-180
• 全文大小：369 KB
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  2. Pescatori M, Gagliardi G. Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures. Tech Coloproctol. 2008;12:7鈥?9. CrossRef
  3. Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol. 1995;90:610鈥?.
  4. Sohn N, Aronoff JS, Cohen FS, Weinstein MA. Transanal hemorrhoidal dearterialization is an alternative to operative hemorrhoidectomy. Am J Surg. 2001;182:515鈥?. CrossRef
  5. Dal Monte PP, Tagariello C, Sarago M, Giordano P, Shafi A, Cudazzo E, et al. Transanal haemorrhoidal dearterialisation: nonexcisional surgery for the treatment of haemorrhoidal disease. Tech Coloproctol. 2007;11:333鈥?. CrossRef
  6. Ratto C, Donisi L, Parello A, Litta F, Doglietto GB. Evaluation of transanal hemorrhoidal dearterialization as a minimally invasive therapeutic approach to hemorrhoids. Dis Colon Rectum. 2010;53:803鈥?1. CrossRef
  7. Infantino A, Altomare DF, Bottini C, Bonanno M, Mancini S. THD group of the SICCR (Italian Society of Colorectal Surgery), et al. Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. Colorectal Dis. 2012;14:205鈥?1. CrossRef
  8. Giordano P, Nastro P, Davies A, Gravante G. Prospective evaluation of stapled haemorrhoidopexy versus transanal haemorrhoidal dearterialisation for stage II and III haemorrhoids: three-year outcomes. Tech Coloproctol. 2011;15:67鈥?3. CrossRef
  9. Faucheron JL, Poncet G, Voirin D, Badic B, Gangner Y. Doppler-guided hemorrhoidal artery ligation and rectoanal repair (HAL-RAR) for the treatment of grade IV hemorrhoids: long-term results in 100 consecutive patients. Dis Colon Rectum. 2011;54:226鈥?1. CrossRef
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  13. Khafagy W, El Nakeeb A, Fouda E, Omar W, Elhak NG, Farid M, et al. Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology. 2009;56:1010鈥?.
  14. Tsunoda A, Sada H, Sugimoto T, Kano N, Kawana M, Sasaki T, et al. Randomized controlled trial of bipolar diathermy vs ultrasonic scalpel for closed hemorrhoidectomy. World J Gastrointest Surg. 2011;3:147鈥?2. CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Thoracic Surgery
  Vascular Surgery
  Cardiac Surgery
  Surgical Oncology
  
• 出版者：Springer Japan
• ISSN：1436-2813

文摘

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.