Doppler-guided transanal hemorrhoidal dearterilization versus conventional hemorrhoidectomy for treatment of hemorrhoids – early and long-term postoperative results
Autor: | A. Taseva, A. Yonkov, Violeta Dimitrova, G. Korukov, Zhivkov E, N. Kandilarov, Bonev S, Bulanov D, L. Simonova, Elena Arabadzhieva, V. Popov, V. Tasev |
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Rok vydání: | 2019 |
Předmět: |
Adult
Hemorrhoidectomy Male medicine.medical_specialty Adolescent Visual analogue scale Conventional hemorrhoidectomy Postoperative pain lcsh:Surgery Hemorrhoids Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Recurrence medicine Postoperative results Humans Postoperative Period Prospective Studies Long-term outcomes Stage (cooking) Transanal hemorrhoidal dearterilization Aged Pain Postoperative business.industry Significant difference Rectum Ultrasonography Doppler Mean age lcsh:RD1-811 General Medicine Length of Stay Middle Aged medicine.disease Surgery Treatment Outcome Patient Satisfaction 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Prospective research business Research Article |
Zdroj: | BMC Surgery, Vol 19, Iss 1, Pp 1-6 (2019) BMC Surgery |
ISSN: | 1471-2482 |
DOI: | 10.1186/s12893-019-0469-9 |
Popis: | Background A variety of effective methods for treatment of hemorrhoids has been proposed. In recent years, there has been an increasing number of studies comparing transanal hemorrhoidal dearterilization (THD) and conventional hemorrhoidectomy (CH), but the focus of most studies has been about the early postoperative results. The data about long-term outcomes is still limited. We aimed to compare Doppler-guided THD and CH with regard to early and long-term postoperative results. Methods The conducted prospective research included 287 patients who underwent CH (167 cases) or Doppler-guided THD with mycopexy (120 patients) between November 2010 and December 2015. Information on hemorrhoidal stage, demographic data, presenting symptoms, complications, duration of hospital stay, postoperative pain, patients’ satisfaction and follow-up were obtained. Statistical tests were performed by SPSS 19.0. Results There was no significant difference between the studied groups according to gender, mean age, preoperative prolapse, pain and pruritus, hemorrhoidal stage and postoperative complications. Preoperative bleeding was more frequent in THD group (p = 0,002). The mean visual analog scale (VAS) pain scores in CH and THD groups on days 1, 2 and 7 were 7.01 vs 5.03, 5.07 vs 2.98, 2.39 vs 0,57 (p = 0,000). Practically, there was no difference in VAS on day 30 and patients’ satisfaction at the 18th month. Mean hospital stay was 5,13 (CH) and 3,38 days (THD), p = 0,000. The postoperative follow-up was between 18 and 78 months (mean 46 ± 16 months). During this stage, 5 patients (2,99%) in CH group required surgery for recurrence. In THD group, 3 patients (2,5%), all with 4th-degree hemorrhoids underwent additional procedures (p 0,802). Conclusions Doppler-guided THD seems to be an efficient and safe option for treatment of hemorrhoids, related to lower postoperative pain and excellent, similar long-term outcomes compared to CH. For advanced grades of hemorrhoids, Doppler-guided THD could be a valuable alternative, but there is a need for patients’ selection. Trial registration (retrospectively registered) researchregistry3090. |
Databáze: | OpenAIRE |
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