title: Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials.
abstract: BACKGROUND
  The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids.
  
  
  METHODS
  Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random effects models.
  
  
  RESULTS
  Four trials, including 316 patients, met the inclusion criteria. No statistically significant differences were noted in either total complications or postoperative bleeding, incontinence, recurrent prolapse, and urinary retention rate. Operative time was significantly longer for THDm with Doppler guidance than for THDm without Doppler guidance. Patients returned to normal activities faster after THDm than after OH. No statistically significant differences between THDm and OH were noted with regard to recurrence and reoperation rates.
  
  
  CONCLUSIONS
  Our meta-analysis shows that THDm and OH are equally effective and can be attempted for the management of hemorrhoids. However, for THDm with Doppler guidance, more instruments and a longer operative time are required. Future large-scale, high-quality, multicenter trials with long-term outcomes are needed to prove these results and determine whether Doppler guidance in THD is truly necessary or not.
authors.affiliation: Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China. xlzjszyy@163.com.
authors.forename: L
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Gastrointestinal Endoscopy, Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People's Republic of China.
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
authors.forename: G
authors.initials: G
authors.lastname: Lin
authors.affiliation: Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
authors.forename: Q
authors.initials: Q
authors.lastname: Ge
authors.affiliation: Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
authors.forename: H
authors.initials: H
authors.lastname: Qi
authors.affiliation: Department of Coloproctology, First Affiliated Hospital of Zhejiang, Chinese Medical University, No. 54 Youdian Rd, Shangcheng District, Hangzhou, 310006, Zhejiang Province, People's Republic of China.
authors.forename: X
authors.initials: X
authors.lastname: He
mesh_terms: D000328:Adult; D001003:Anal Canal / Q000098:blood supply / Q000601:surgery*; D001158:Arteries / Q000601:surgery*; D005260:Female; D061865:Hemorrhoidectomy / Q000379:methods / Q000706:statistics & numerical data*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016032:Randomized Controlled Trials as Topic; D000067368:Transanal Endoscopic Surgery / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D055815:Young Adult
keywords: Artery ligation; Dearterialization; Hemorrhoids; Meta-analysis; Mucopexy