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

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.

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)

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.

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