Transanal hemorrhoidal dearterialization versus stapled hemorrhoidectomy in the treatment of hemorrhoids

Song, Yan; Chen, Honglei; Yang, Fang; Zeng, Yuheng; He, Yongheng; Hui-yong, Huang

doi:10.1097/md.0000000000011502

Cited by 17 publications

(12 citation statements)

References 24 publications

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“…Lehur also found that DGHAL resulted in less pain than SH (108). Song could not show a difference in pain (109).…”

Section: Specific Conditions A) Pregnancymentioning

confidence: 85%

“…DGHAL resulted in less bleeding compared to open and stapled procedures and fewer reoperations than open, closed and Ligasure® procedures (102). Song confirmed that there was less bleeding and that the recurrence rate of DGHAL was higher on short term follow up but equal on long term follow up (109). Single center studies found that DGHAL was not inferior to conventional excisional hemorrhoidectomy for advanced disease in term of operative complications and long-term recurrence of symptoms (110,111).…”

Section: Specific Conditions A) Pregnancymentioning

confidence: 94%

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Belgian consensus guideline on the management of hemorrhoidal disease

Schepper¹,

Coremans²,

Denis³

et al. 2021

AGEB

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Introduction : Hemorrhoidal disease is a common problem that arises when hemorrhoidal structures become engorged and/or prolapse through the anal canal. Both conservative and invasive treatment options are diverse and guidance to their implementation is lacking. Methods : A Delphi consensus process was used to review current literature and draft relevant statements. These were reconciliated until sufficient agreement was reached. The grade of evidence was determined. These guidelines were based on the published literature up to June 2020. Results : Hemorrhoids are normal structures within the anorectal region. When they become engorged or slide down the anal canal, symptoms can arise. Every treatment for symptomatic hemorrhoids should be tailored to patient profile and expectations. For low-grade hemorrhoids, conservative treatment should consist of fiber supplements and can include a short course of venotropics. Instrumental treatment can be added case by case : infrared coagulation or rubber band ligation when prolapse is more prominent. For prolapsing hemorrhoids, surgery can be indicated for refractory cases. Conventional hemorrhoidectomy is the most efficacious intervention for all grades of hemorrhoids and is the only choice for non-reducible prolapsing hemorrhoids. Conclusions : The current guidelines for the management of hemorrhoidal disease include recommendations for the clinical evaluation of hemorrhoidal disorders, and their conservative, instrumental and surgical management.

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“…Lehur also found that DGHAL resulted in less pain than SH (108). Song could not show a difference in pain (109).…”

Section: Specific Conditions A) Pregnancymentioning

confidence: 85%

Section: Specific Conditions A) Pregnancymentioning

confidence: 94%

Belgian consensus guideline on the management of hemorrhoidal disease

Schepper¹,

Coremans²,

Denis³

et al. 2021

AGEB

View full text Add to dashboard Cite

show abstract

“…Moreover, concerning the recurrence rate, it is surprisingly unclear how in some studies transanal hemorrhoidal dearterialization/hemorrhoidal artery ligation and rectoanal repair show similar or even better results when compared to SH for the same cluster of patients [26,27]. Theoretically, SH should hang the hemorrhoids higher than what the mucosuspension can reach, and interrupts the down-streaming arterial flow more efficiently than single or multiple arterial ligations may do using absorbable sutures.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of high-volume stapled hemorroidopexy to treat symptomatic hemorrhoidal disease

et al. 2023

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The study aimed to assess the long-term results of the stapled hemorrhoidopexy (SH) using high-volume devices equipped with innovative technology, evaluating recurrence rate, complications rate, and patients' satisfaction. Methods: All the patients who underwent SH using high-volume devices (TST Starr plus, Touchstone International Medical Science Corp., Ltd.) for II to IV symptomatic hemorrhoidal disease from November 2012 to December 2014 were enrolled. Between December 2019 and January 2020, all of them were phone called to come to undergo a proctological reevaluation and asked to fill some questionnaires about hemorrhoidal prolapse recurrence, symptoms recurrence, and surgery satisfaction. Results: Fifty-nine patients with a mean age of 47 years completely answered the questionnaires. Twenty-two of them accepted to come to undergo a proctological reevaluation while 27 preferred to answer only by phone due to their referred wellbeing. The median follow-up was 70.5 months (range, 60-84 months). The recurrence rate was 5.1% with a mean satisfaction level after surgery was 9.1 (range, 0-10) and 84.7% of patients whose satisfaction scored ≥ 8. The mean value of Cleveland Global Quality of Life assessment was 0.79 (range, 0.71-0.93). There were no cases of new onset of impaired anal continence after surgery. Conclusion: The new generation high-volume devices to perform SH resulted to be safe and effective for II to IV degree hemorrhoidal prolapse leading to a lower long-term recurrence rate with an evident reduction of postoperative complications in comparison with the low-volume SH.

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“…To show the effectiveness of supplementation of HAL to LHP in reducing the post-operative bleeding incidence by 20% [24], we needed to study 35 experimental subjects and 35 control subjects to be able to…”

Section: Sample Size Estimationsmentioning

confidence: 99%

Comparison of Post-operative Bleeding Incidence in Laser Hemorrhoidoplasty with and without Hemorrhoidal Artery Ligation: A Double-Blinded Randomized Controlled Trial

Lim

Rajandram

Roslani

2022

Preprint

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Purpose: To investigate the effectiveness of hemorrhoidal artery ligation supplementation in reducing the incidence of post laser hemorrhoidoplasty bleeding.Method: This was a double-blind, randomized controlled trial comparing post-operative bleeding incidence in patients undergoing laser hemorrhoidoplasty (LHP) only versus LHP with hemorrhoidal artery ligation (HAL). Outcome measures included post-operative bleeding and its severity (i.e. verbal rating scale and Clavien-Dindo classification), presence of perianal swelling and pain score (visual analog score) at 1-day, 1-week and 6-weeks post-operatively. Statistical tests were performed and a value of P<0.05 was considered significant. Results: Seventy-six patients were randomized. There was no difference in median operating time. The bleeding incidence was highest at 1-week post-operatively (17.1%), and decreased to 1.3% at 6-weeks. There was no significant difference in bleeding incidence between both groups at any of the measured timepoints (P>0.05). Severity of bleeding and incidence of post-operative perianal swelling were similar in both groups (P>0.05). There was no difference in median pain scores. Conclusion: Supplementation of HAL to LHP does not reduce the post-operative bleeding incidence. LHP is sufficient as a stand-alone procedure for treating haemorrhoids.Trial Registration:National Registration Number is NMRR-15-1112-24065 (IIR). The trial start date was 1st January 2015 with the ClinicalTrials.gov identifier and registration number as NCT04667169.

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Transanal hemorrhoidal dearterialization versus stapled hemorrhoidectomy in the treatment of hemorrhoids

Cited by 17 publications

References 24 publications

Belgian consensus guideline on the management of hemorrhoidal disease

Belgian consensus guideline on the management of hemorrhoidal disease

Long-term outcomes of high-volume stapled hemorroidopexy to treat symptomatic hemorrhoidal disease

Comparison of Post-operative Bleeding Incidence in Laser Hemorrhoidoplasty with and without Hemorrhoidal Artery Ligation: A Double-Blinded Randomized Controlled Trial

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