Trans-anal haemorrhoidal de-arterialisation in the management of haemorrhoids: a literature based review: P174

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Aim:To review the literature and analyse the effectiveness of trans-anal haemorrhoidal de-arterialisation (THD) in the management of symptomatic haemorrhoids.Method:A systematic review of the literature was undertaken to analyse the published studies on THDResults:There were 18 case series on THD encompassing 2790 patients. The reported symptomatic relief after THD varied from 71% to 100%. Disease cure rate was reported between 80-96%. The isolated symptom control was 70-97.5% for pain, 88-91% for rectal bleeding and 92-94% forprolapse. Two published randomised trials comparing conventional haemorrhoidectomy (CH) with THD were analysed using theprinciples of meta-analysis. Ninety-one patients underwent CH and 59 patients had THD. Combined calculation of operation time, hospital stay and postoperative pain was not possible due to insufficient reported data. THD is associated with fewer postoperative complications as compared to CH. There is no statistically significant difference in haemorrhoidal recurrence rate in both groups.Conclusion:THD is a safeprocedure associated with few postoperative complications. Recurrence rate, symptomatic relief and disease cure rate is also comparable to CH.

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