Transanal haemorrhoidal de-arterialisation: changing trends in haemorrhoid surgery

Fretwell V. & Khan A.
Colorectal Disease, Volume 16, Supplement 3 (September 2014), P366

Transanal haemorrhoidal dearterialisation (THD) is a non-excisional approach to the treatment of haemorrhoids. We present 5 years experience with the technique.

Data were prospectively collected between February 2009 and February 2014 for a single Consultant Colorectal Surgeon. Data collected included grade of haemorrhoids, previous treatments, performance of haemorrhoidopexy or other procedure, post operative complications including pain and the need for repeat procedures.

One hundred and ninety five patients were included (M:F 107:88, median age 51). Sixty three per cent had grade 3 haemorrhoids with 76% having had rubber band ligation previously. Sixty patients had THD alone and in 128 it was combined with haemorrhoidopexy. Routine post operative outpatient follow up was discontinued after February 2012 due to favourable results (92% asymptomatic at 2 months). Overall 6 patients had post operative pain requiring morphine administration in the recovery room, 1 patient was re-admitted with bleeding, 5 patients required further surgery and 3 had recurrence of minor symptoms not requiring further surgery.

The THD procedure is a new but safe, cost efficient and effective treatment for grade 2 and 3 haemorrhoids and with considerably lower morbidity than traditional open haemorrhoidectomy.