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Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids.
Colorectal Dis. 2012 Feb; 14(2):205-11.CD

Abstract

AIM

Doppler-guided transanal haemorrhoid dearterialization (THD) and stapler haemorrhoidopexy (SH) have been demonstrated to be less painful than the Milligan-Morgan procedure. The aim of this study was to compare the effectiveness of THD vs SH in the treatment of third-degree haemorrhoids in an equivalent trial.

METHOD

One hundred and sixty-nine patients with third-degree haemorrhoids were randomized online to receive THD (n = 85) or SH (n = 84) in 10 Colorectal Units in which the staff were well trained in both techniques. The mean follow-up period was 17 (range 15-20) months.

RESULTS

Early minor postoperative complications occurred in 30.6% of patients in the THD group and in 32.1% of patients in the SH group. Milder spontaneous pain and pain on defecation were reported in the THD group in the first postoperative week, but this was not statistically significant. Late complications were significantly higher (P = 0.028) in the SH group. Residual haemorrhoids persisted in 12 patients in the THD group and in six patients in the SH group (P = 0.14). Six patients in the SH group and 10 in the THD group underwent further treatment of haemorrhoids (P = 0.34). No differences were found in postoperative incontinence. The obstructed defecation score (ODS) was significantly higher in the SH group (P < 0.02). Improvement in quality of life was similar in both groups. Postoperative in-hospital stay was 1.14 days in the THD group and 1.31 days in the SH group (P = 0.03).

CONCLUSION

Both THD and SH techniques are effective for the treatment of third-degree haemorrhoids in the medium term. THD has a better cost-effective ratio and lower (not significant) pain compared with SH. Postoperative pain and recurrence did not differ significantly between the two groups.

Authors+Show Affiliations

Department of Surgery, S. Maria dei Battuti Hospital, S. Vito al Tagliamento, PN, Italy. aldo.infantino@mac.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

21689317

Citation

Infantino, A, et al. "Prospective Randomized Multicentre Study Comparing Stapler Haemorrhoidopexy With Doppler-guided Transanal Haemorrhoid Dearterialization for Third-degree Haemorrhoids." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 14, no. 2, 2012, pp. 205-11.
Infantino A, Altomare DF, Bottini C, et al. Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. Colorectal Dis. 2012;14(2):205-11.
Infantino, A., Altomare, D. F., Bottini, C., Bonanno, M., Mancini, S., Yalti, T., Giamundo, P., Hoch, J., El Gaddal, A., & Pagano, C. (2012). Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 14(2), 205-11. https://doi.org/10.1111/j.1463-1318.2011.02628.x
Infantino A, et al. Prospective Randomized Multicentre Study Comparing Stapler Haemorrhoidopexy With Doppler-guided Transanal Haemorrhoid Dearterialization for Third-degree Haemorrhoids. Colorectal Dis. 2012;14(2):205-11. PubMed PMID: 21689317.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. AU - Infantino,A, AU - Altomare,D F, AU - Bottini,C, AU - Bonanno,M, AU - Mancini,S, AU - ,, AU - Yalti,T, AU - Giamundo,P, AU - Hoch,J, AU - El Gaddal,A, AU - Pagano,C, PY - 2011/6/22/entrez PY - 2011/6/22/pubmed PY - 2012/5/10/medline SP - 205 EP - 11 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 14 IS - 2 N2 - AIM: Doppler-guided transanal haemorrhoid dearterialization (THD) and stapler haemorrhoidopexy (SH) have been demonstrated to be less painful than the Milligan-Morgan procedure. The aim of this study was to compare the effectiveness of THD vs SH in the treatment of third-degree haemorrhoids in an equivalent trial. METHOD: One hundred and sixty-nine patients with third-degree haemorrhoids were randomized online to receive THD (n = 85) or SH (n = 84) in 10 Colorectal Units in which the staff were well trained in both techniques. The mean follow-up period was 17 (range 15-20) months. RESULTS: Early minor postoperative complications occurred in 30.6% of patients in the THD group and in 32.1% of patients in the SH group. Milder spontaneous pain and pain on defecation were reported in the THD group in the first postoperative week, but this was not statistically significant. Late complications were significantly higher (P = 0.028) in the SH group. Residual haemorrhoids persisted in 12 patients in the THD group and in six patients in the SH group (P = 0.14). Six patients in the SH group and 10 in the THD group underwent further treatment of haemorrhoids (P = 0.34). No differences were found in postoperative incontinence. The obstructed defecation score (ODS) was significantly higher in the SH group (P < 0.02). Improvement in quality of life was similar in both groups. Postoperative in-hospital stay was 1.14 days in the THD group and 1.31 days in the SH group (P = 0.03). CONCLUSION: Both THD and SH techniques are effective for the treatment of third-degree haemorrhoids in the medium term. THD has a better cost-effective ratio and lower (not significant) pain compared with SH. Postoperative pain and recurrence did not differ significantly between the two groups. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/21689317/Prospective_randomized_multicentre_study_comparing_stapler_haemorrhoidopexy_with_Doppler_guided_transanal_haemorrhoid_dearterialization_for_third_degree_haemorrhoids_ L2 - https://doi.org/10.1111/j.1463-1318.2011.02628.x DB - PRIME DP - Unbound Medicine ER -