| Evaluation of transanal hemorrhoidal dearterialization as a minimally invasive therapeutic approach to hemorrhoids. | |
| | |
MedLine Citation:
|
PMID: 20389215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
PURPOSE: Transanal hemorrhoidal dearterialization is an innovative technique to treat hemorrhoids using a specially designed proctoscope for Doppler-guided transanal ligation of hemorrhoidal arteries. We analyzed results of experience at a single-institution with this transanal hemorrhoidal dearterialization device. METHODS: Overall, 170 patients were submitted to transanal hemorrhoidal dearterialization during the period July 2005 through October 2008. The operation consisted of hemorrhoidal dearterialization (of 6 arteries) in all patients, with major mucosal/submucosal pexy in 56 patients (32.9%). The first consecutive 11 patients (6.4%) were treated under general/spinal anesthesia, the remaining 159 (93.6%) by sedation with propofol, supported by analgesia with remifentanil. Following transanal hemorrhoidal dearterialization surgery, patients were regularly evaluated at 2 weeks, 1 and 3 months, and once a year after operation. RESULTS: The mean age of the 170 patients was 47.3 +/- 13.0 years; 102 (60%) were men. Hemorrhoidal disease was grade II in 13 (7.6%); grade III in 141 (82.7%), and grade IV in 16 (9.6%). Postoperative bleeding requiring surgical hemostasis occurred in 2 cases (1.2%). Mean follow-up was 11.5 +/- 12 (range, 1-41) months. Hemorrhoidal thrombosis occurred in 4 patients (2.3%), chronic pain and fecal incontinence in none. Hemorrhoidal prolapse was reported at follow-up by 50 patients (29.5%), but prolapse was confirmed only in 18 (10.5%) and was mild; some patients reporting prolapse were found to have skin tags. Overall, long-term control of bleeding was obtained in 159 patients (93.5%) and control of prolapse in 152 (89.5%). Recurrence of hemorrhoidal disease requiring surgery was found in 7 patients (4.1%). CONCLUSIONS: Transanal hemorrhoidal dearterialization appears to be a very effective minimally invasive option to treat hemorrhoids and can be performed in a day-surgery setting. Future controlled trials comparing transanal hemorrhoidal dearterialization with other procedures will show the real potential of transanal hemorrhoidal dearterialization and define adequate indications for this approach. |
| | |
Authors:
|
Carlo Ratto; Lorenza Donisi; Angelo Parello; Francesco Litta; Giovanni Battista Doglietto |
Related Documents
:
|
18813985 - Role of three-dimensional anorectal ultrasonography in the assessment of rectal cancer ... 12366425 - Application of imiquimod by suppositories (anal tampons) efficiently prevents recurrenc... 22607575 - Corporate sponsors. 14702645 - Long-term study on the effects of visual biofeedback and muscle training as a therapeut... 20420345 - Experience with a medicolegal decision-making system for occupational hearing loss-rela... 20442365 - A novel prognostic model in elderly patients with acute myeloid leukemia: results of 90... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Diseases of the colon and rectum Volume: 53 ISSN: 1530-0358 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-04-14 Completed Date: 2010-05-06 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: United States |
Other Details:
|
Languages: eng Pagination: 803-11 Citation Subset: IM |
Affiliation:
|
Department of Surgical Sciences, Catholic University, Rome, Italy. carloratto@tiscali.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anal Canal
/
blood supply*,
surgery* Chi-Square Distribution Female Hemorrhoids / surgery* Hemostasis, Surgical Humans Male Middle Aged Patient Satisfaction Postoperative Complications Statistics, Nonparametric Surgical Procedures, Minimally Invasive / methods* Treatment Outcome Ultrasonography, Interventional |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Long-term outcomes with the use of bioprosthetic plugs for the management of complex anal fistulas.
Next Document: Patient-performed seton irrigation for the treatment of deep horseshoe fistula.