title: Comparison of the early results of transanal hemorrhoidal dearterialization and hemorrhoidectomy using an ultrasonic scalpel.
abstract: OBJECTIVE
  Doppler-guided transanal hemorrhoidal dearterialization and mucopexy (THD surgery) is a new approach for treating hemorrhoids. The early results of the procedure are presented and compared with those of hemorrhoidectomy using an ultrasonic scalpel (US surgery).
  
  
  METHODS
  Thirty-six patients with grade III hemorrhoids underwent the THD surgery and were compared with a cohort of 30 patients with grade III or IV hemorrhoids who were assigned to US surgery in a previous randomized trial.
  
  
  RESULTS
  The pain scores were significantly lower in the THD patients on days 6 and 7 after the operation. The number of analgesic tablets consumed during the first postoperative week in the THD patients was significantly lower than that in the US patients. The blood loss was significantly greater in the THD patients. The hospital stay and length of time until the first defecation after surgery were both significantly shorter in the THD patients. The postoperative complications were comparable between the two groups of patients.
  
  
  CONCLUSIONS
  The THD surgery was as effective as the US surgery for the treatment of hemorrhoids in the short term. THD surgery might be a preferred treatment because it is associated with a similar complication rate and short-term results, but results in lower postoperative pain and analgesic requirements compared with the US surgery.
authors.affiliation: Department of Surgery, Kameda Medical Center, 929 Higashicho, Kamogawa, Chiba, 296-8602, Japan, a.tsunoda@kameda.jp.
authors.forename: Akira
authors.initials: A
authors.lastname: Tsunoda
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kiyasu
authors.forename: Wataru
authors.initials: W
authors.lastname: Fujii
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Kano
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000098:blood supply* / Q000601:surgery*; D001158:Arteries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D061865:Hemorrhoidectomy / Q000295:instrumentation / Q000379:methods*; D006484:Hemorrhoids / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional; D055815:Young Adult