Outcomes following Transanal Haemorrhoidal Dearterialisation (THD)

Baig M., Patel R., Khan A. U. et al. Leighton Hospital, Crewe, United Kingdom
P555 Poster Abstract, Colorectal Disease 20 (Suppl. 4), 33–140

Although conventional open haemorrhoidectomy and stapled haemorrhoidectomy are effective procedures, they can lead to significant post-operative pain with risks to continence.Current evidence favours transanal haemorrhoidal dearterialisation (THD) and targeted mucopexy (TM) to be an efficacious alternative to conventional modalities. Our aim was to assess the midterm outcomes following THD.

Retrospective data was collected for patients undergoing day case THD under a single consultant over a 9-year period (March 2009 to February 2018). Data collected included: intra-operative findings, post-operative pain as (defined as requirement of analgesia in recovery), post-operative complications and requirement of further procedures.

271 patients underwent THD and TM in 203 (74.9%) patients with 2ndto 4thdegree haemorrhoids. Only 4 (1.5%) patients suffered from post-operative complications, including significant bleeding (n = 1) urinary retention (n = 1) and constipation (n = 2). Post-operative pain was identified in 10 (3.7%) patients that also required an additional procedure (e.g. excision of anal polyps and skin tags). Only 5 (1.8%) patients required further haemorrhoidal invasive intervention subsequently.

These results are comparable with national data and demonstrate that THD is a safe procedure for symptomatic haemorrhoids with minimal morbidity and is a trainable operation for colorectal residents.