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To explore the short term results of THD.From 2005 to 2009, 264 patients were treated with THD at our institute. All patientspreviously underwent rubber band ligation. Theprocedure was performed in day care and was carried out by the same surgeon. The six terminal branches of the superior rectal artery were located with Doppler and then sutured.Two hundred and sixty-four patients were studied of whom 26% patients had grade II, 53% grade III and 21% grade IV haemorrhoids. The main complaints were blood loss in 49%, pain 24%,prolapse 5% and swelling 11%. After a median follow up of 4.4 months the overall success rate (symptom free) was 70%. 40 patients underwent a second THDprocedure. Success percentages for grade II, III and IV haemorrhoids were 72%, 76% and 69% respectively. Post-operative complications occurred in 25 (9%) patients, including bleeding in seven (3%), severe anal pain in 10 (4%), urinary retention in one (0.4%) patient. Rehospitalization was necessary in three patients.THD is a safe and effective treatment for grade II-IV hemorrhoids. In most patients open haemorrhoidectomy can beprevented.