THD for thrombosed haemorrhoids

Trenchuk V., Lagoda V., Tchornous I.
Colorectal Disease 2013, 15 (Suppl. 3), 48-116, Poster 326 from ESCP Meeting 2013 in Belgrade

Improvement of efficacy and safety of thrombosed haemorrhoids treatment using THD procedure.

In 1995 Morinaga described a new technique for surgical treatment of haemorrhoids – Transanal Haemorrhodail Dearterialisation (THD). This technique eliminates haemorrhoidal symptoms by Doppler-guided ligation of SRA terminal branches. Procedures were performed using THD.

Thrombosed piles (grade I-II) were treated by standard conventional treatment 3-4 days prior operation. After acute inflammatory signs elimination, THD procedure was performed. Operational window in the distal part of special anoscope with incorporated Doppler probe allowed applying stitches on arteries under spinal anesthesia. From October 2010 THD procedure were performed in 132 patients (71.5% male, age range 20-72 years). The majority (70%) had grade III haemorrhoids including 45 patients with acute thrombosed piles. After procedure 57, 3% of patients had no pain symptoms. Hospital stay lasted 1 day (2-3 days in case of thrombosed piles). We have observed 2 complications: two cases of intraoperational bleeding followed by additional ligation. Patients fully recovered in 3-5 days. In 3 years follow-up any serious complications or recurrence haven’t been registered.

This study presents THD procedure as safe, effective, non-excisional, anatomy-saving, 1 day surgery for haemorrhoids without post-operational impact on continence.