title: [Comparison of Doppler-assisted dearterialization with mucopexy and hemorrhoidectomy].
abstract: OBJECTIVE
  To compare two methods of hemorrhoid treatment.
  
  
  METHODS
  This prospective study included 240 patients with hemorrhoids stage III-IVA. Stages III and IVA were diagnosed in 156 (65%) and 84 (35%) patients respectively. Randomization was performed using envelopes method in one to one distribution. In group 1 (n=120) Doppler-assisted dearterialization of internal hemorrhoids with mucopexy was performed (DDM), in group 2 (n=120) - hemorrhoidectomy using harmonic scalpel (HE).
  
  
  RESULTS
  Duration of surgery was 17.9±6.1 and 34.5±10.1 minutes in DDM and HE groups respectively (p<0.01). Postoperative pain severity was higher in group 2 (4.8 compared with 2.5 scores of the first group (p<0.01). Narcotic analgesics were used less often in DDM group (1.3 doses compared with 6.1 doses in HE group (p<0.01). Disability period was 14.4±5.2 and 30.3±5.4 days in both groups respectively (p<0.01). Immediate postoperative complications occurred in 9 (7.5%) and 19 (15.8%) patients of DDM and HE groups respectively. Recurrent prolapse of internal hemorrhoids was diagnosed in 2 (1.7%) patients of the 1st group in terms of up to 45 days.
  
  
  CONCLUSIONS
  DDM is reliable minimally invasive method of hemorrhoids stage III-IVA treatment and has similar efficacy with HE. DDM reduces postoperative pain severity, hospital stay and disability period.
authors.affiliation: A.N. Ryzhykh State Research Center of Coloproctology, Health Ministry of the Russian Federation, Moscow.
authors.forename: A Iu
authors.initials: AI
authors.lastname: Titov
authors.affiliation: A.N. Ryzhykh State Research Center of Coloproctology, Health Ministry of the Russian Federation, Moscow.
authors.forename: M V
authors.initials: MV
authors.lastname: Abritsova
authors.affiliation: A.N. Ryzhykh State Research Center of Coloproctology, Health Ministry of the Russian Federation, Moscow.
authors.forename: A A
authors.initials: AA
authors.lastname: Mudrov
mesh_terms: D000328:Adult; D057186:Comparative Effectiveness Research; D004867:Equipment Design; D005260:Female; D061865:Hemorrhoidectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006484:Hemorrhoids / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D020700:Proctoscopes; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D014656:Vascular Surgical Procedures / Q000379:methods