Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: An Italian single-institution 5-year experience analysis and updated literature review

• DOI: 10.3389/fsurg.2022.1088546
• Publication Date: 2022-12-21T06:05:56Z
• Authors: Luigi Verre; Gaetano Gallo; Giulia Grassi; Edoardo Bussolin; Ludovico Carbone; Gianmario Edoardo...; Osvaldo Carpineto...; Luigi Marano; Daniele Marrelli; Franco Roviello
• Keywords: Gold standard (test)

Background Hemorrhoidal disease is a highly prevalent, chronic disorder that usually compromise patients' quality of life. Despite recent advances in pharmacologic and surgical therapeutic options, clear treatment “gold standard” lacking. Our aim to analyze the outcomes following Transanal Dearterialization (THD) procedure. Methods Patients who failed conservative underwent THD Doppler between 2017 2021 were enrolled. Follow-up interviews (consisting clinical examination, Visual Analog Scale for pain—VAS, Vaizey incontinence score, Hemorrhoid Severity Score) administered 1 week, 2 weeks, month 6 months after surgery. Results Forty-seven out 75 patients male, mean age was 50 (± 17.9) years. Hemorrhoids classified as Goligher's degree II 25 cases, III 40 IV, simple irreducible without ischemic changes, 10. The operative time 35 (28–60) minutes, most procedures performed with epidural anesthesia (80%). No intraoperative complications occurred, 73 (97.3%) discharged within post-operative day 1. Early pain bleeding occurred 37.3% 8% patients, respectively. experienced anal severe symptoms at overall success rate 97.3%. Conclusions safe effective hemorrhoidal if bleeding, III, IV both first intervention on recurrence. Physician patient need understand each other's expectations, weight risks benefits, customize treatment.