title: Evaluation of transanal hemorrhoidal dearterialization: a single surgeon experience.
abstract: BACKGROUND
  There is an increasing, though still limited, amount of evidence describing the use of the transanal hemorrhoidal dearterialization (THD) device for the treatment of hemorrhoidal disease. This study assesses postoperative outcomes from a single surgeon experience with the THD device.
  
  
  METHODS
  From January 2009 to December 2011, 108 THD procedures were performed. With Doppler guidance, the THD device makes possible precise ligation of the branches of the superior hemorrhoidal artery. Patients were seen postoperatively at 3 weeks and 6 months. They underwent physical examination to determine whether there was recurrence of hemorrhoidal prolapse. They were asked to describe any bleeding, to rate pain using the visual analog scale, and to rate their level of satisfaction on a scale of 1-5 (with 5 = highly satisfied). A phone interview was used for follow-up at 1 year to determine the rate of recurrent prolapse.
  
  
  RESULTS
  Of the 108 patients who underwent THD, two were lost to follow-up and excluded. All of the remaining 106 patients completed follow-up at 3 weeks and 6 months. At 3 weeks, 92% of patients had no pain and 88% were highly satisfied with the procedure at 3 weeks. This increased to 92% satisfaction at 1 year. Prolapse recurrence was 7.5% at 6 months and 10.3% at 1 year. Bleeding was the most common complication, but did not require re-intervention or transfusion.
  
  
  CONCLUSIONS
  THD is a same-day procedure for the treatment of hemorrhoidal disease that is safe and effective, and offers the potential for immediate return to normal activity.
authors: Division of Colon and Rectal Surgery and Trauma Surgery, Department of Surgery, Bethesda North and Good Samaritan TriHealth Hospital, Cincinnati, OH, USA, drlabella@gmail.com.
authors: G D
authors: GD
authors: LaBella
authors: W P L
authors: WP
authors: Main
authors: L R
authors: LR
authors: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000098:blood supply*; D001158:Arteries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011446:Prospective Studies; D012005:Rectal Prolapse; D012008:Recurrence; D000067368:Transanal Endoscopic Surgery; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods / Q000523:psychology
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