2013

Efficacy of THD Doppler procedure in treating hemorrhoidal symptoms


Ratto C., Parello A., Donisi F., Litta G. et al.
Colorectal Disease 2013, 15 (Suppl. 3), 48-116, Poster LTP90 from ESCP Meeting 2013 in Belgrade

AIM:
Doppler-guided Transanal Hemorrhoidal Dearterialization (THD) seems able to influence effectively pathophysiology of hemorrhoidal disease (HD). Clinical efficacy of THD Doppler procedure in patients with HD has been evaluated.

METHOD:
Clinical assessment of 626 HD patients, treated with this surgical technique (including dearterialization mucopexy), was performed pre- and postoperatively (mean follow-up: 33.9 ± 22.2; range: 12-100 months). A HD-specific symptom-based score was used including evaluation of: bleeding, prolapse, manual reduction, discomfort/pain, impact on QoL (severity graded as: 0 = never; 1 = at least once/year; 2 = at least once /month; 3 = at least once / week; 4 = every bowel movement)

RESULTS:
The preoperative mean score (15.1 ± 2.8) dropped to 1.2 ± 3.0 postoperatively (P < 0.001). Preoperatively, grade 3-4 symptoms concerned 67.4% of patients for bleeding, 89.2% for prolapse, 75.1% for manual reduction,77.2% for discomfort/pain, 89.0% for impact on QoL. At follow-up, these features were 3.2%, 7.7%, 2.9%, 2.7% and 3.9%, respectively, while grade 0 symptoms concerned 93.6% of patients for bleeding, 89.3% for prolapse, 95.7% for manual reduction, 85.3% for discomfort/pain, 84.2% for impact on QoL.

CONCLUSION:
THD Doppler procedure showed very high efficacy in controlling all HD-related symptoms.

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