A cohort study analysing outcomes following transanal haemorrhoidal dearterialisation (THD)
| Autor: | Rikesh Patel, Mirza Amir Baig, Arif Khan, Adeeb Ur Rehman, M.Ali Kazem |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Constipation Prospective data Anal Canal Hemorrhoids 03 medical and health sciences Open haemorrhoidectomy 0302 clinical medicine medicine Humans Intestinal Mucosa Ligation National data Aged Aged 80 and over Urinary retention business.industry Middle Aged Surgery Additional procedure 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female medicine.symptom business Vascular Surgical Procedures Cohort study |
| Zdroj: | The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland. 19(2) |
| ISSN: | 1479-666X |
| Popis: | Background 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 to be an efficacious alternative to conventional modalities. Our aim was to assess the midterm outcomes following THD. Methods Prospective 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 (defined as requirement of analgesia in recovery), post-operative complications and requirement of further procedures. Results Over this time period, 271 patients underwent THD, with 203 (74.9%) patients also undergoing targeted mucopexy for 2nd to 4th degree 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 only 10 (3.7%) patients; eight of which had simultaneously undergone an additional procedure (e.g. excision of anal polyps and skin tags). Only 5 (1.8%) patients were identified that required further haemorrhoidal invasive intervention subsequently. Conclusions These results are comparable with national data and demonstrate that THD is a safe procedure for symptomatic haemorrhoids with minimal morbidity. |
| Databáze: | OpenAIRE |
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