Transanal Haemorrhoidal Dearterialization (THD) - The French experiencc: LTP42


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Abstract

Aim:THD offers a new option for haemorrhoid treatment. Wepresent the first French THD experience from two expert centres.Method:Ninety patients (51 males), mean age 52.8 ± 12.4 years, underwent THD from Dec 2008 to May 2010. The extent ofprolapse, bleeding, pain, continence and satisfaction wereprospectively assessed,preoperatively and at 1, 3, 6 and 12 months postoperatively, using standardised five-level scales (0-4 maximum). Complete data was available for 64 patients.Results:79.7% of patients had Goligher Grade 2 or 3 haemorrhoids. The indications for surgery wereprolapse in 67.2%, bleeding in 50% and 21.9% having both symptoms. The median number of ligatures placed was 6 (range 4-9), with additional mucopexy performed forprolapse. Postoperatively, two patients had bleeding and one developed a fissure. After a median follow-up of 8 months (range 1-12), there was significant improvement in extent ofprolapse (2.9 ± 1.4 to 1.1 ± 1.4, P < 0.001), bleeding (2.7 ± 1.2 to 0.2 ± 1.9, P < 0.001), pain (3.3 ± 0.9 to 0.5 ± 1.0, P < 0.001) and overall satisfaction (0.2 ± 0.7 to 3.5 ± 0.9, P < 0.001). Anal continence was unaffected and 94% of patients expressed fair to excellent satisfaction. There was one recurrence.Conclusion:THD is a safe and effective treatment option for haemorrhoids.

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