Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids

Keywords: hemorrhoids; ultrasound rectodopplerometry; transanal hemorrhoidal desarterization; submucosal hemorrhoidectomy.

Abstract

Objective. To study the immediate and late follow-up results of treatment in patients, suffering hemorrhoids, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was done, and to compare them with results of treatment in patients, operated in accordance to procedure of standard hemorrhoidectomy.

Materials and methods. There were analyzed the results of treatment of 111 patients, suffering hemorrhoids. The main group have consisted of 50 patients, to whom transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control was performed. Into control group 61 patients were included, who were operated in accordance to Parks procedure.

Results. In the main group the average time of the operation have constituted (50.1 ± 1.4) min, the patient stationary stay - (9.9 ± 0.7) days, the pain syndrome intensity in postoperative period was estimated as 2 - 3 points, what have appeared significantly lesser, than in the control group of the patients (p < 0.01). Good late follow-up results were achieved in 100% patients of the main group and in 88% of the control group.

Conclusion. There was established, that transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control permits to reduce essentially the average time of the operation, the patients’ stationary stay, to lower the pain syndrome intensity, and to improve late follow-up results of the hemorrhoids treatment.

Author Biographies

A. A. Nykonenko, Zaporozhye State Medical University

Nykonenko Andryi O. - MD, DSci(Med), Professor,
Head of Hospital Surgery Department,
Zaporizhzhia State Medical University,
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
nikonandra@gmail.com
orcid.org/0000-0002-5720-2602

G. I. Okhrimenko, Zaporozhye State Medical University

Okhrimenko Georgiy I. - MD, PhD, Assistant
Hospital Surgery Department,
Zaporizhzhia State Medical University
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
okhrimenko.georgiy@gmail.com
orcid.org/0000-0003-0217-3549

E. I. Haidarzhi, Zaporozhye State Medical University

Haidarzhi Yevhen I. - MD, PhD, Associate Professor
Hospital Surgery Department,
Zaporizhzhia State Medical University,
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
yevhenhaidarzhi@gmail.com
orcid.org/0000-0001-7211-1795

N. G. Golovko, Zaporozhye State Medical University

Golovko Mykola G. - MD, PhD, Associate Professor
Hospital Surgery Department,
Zaporizhzhia State Medical University,
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
ng.golovko@gmail.com
orcid.org/0000-0003-1424-5554

I. V. Zubryk, Zaporozhye State Medical University

Zubryk Iryna V. - MD, PhD, Assistant
Hospital Surgery Department,
Zaporizhzhia State Medical University
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
lirinavit@gmail.com
orcid.org/0000-0002-5578-133X

V. A. Grushka, Zaporozhye State Medical University

Grushka Venedict A. - MD, PhD, Associate Professor
Hospital Surgery Department,
Zaporizhzhia State Medical University,
Maykovskyi avenue 26, 69035, Zaporizhzhia, Ukraine
+38 061 224 63 91
gvenaks631@gmail.com
orcid.org/0000-0001-6249-0306

T. V. Gurov, Zaporozhye Regional Clinical Hospital

Gurov Taras V. - MD
Zaporizhzhia Regional Clinical Hospital
Orichivske str., 10, 69000, Zaporizhzhia, Ukraine
+38 (061) 769-81-81
tarasec4@gmail.com
orcid.org/0000-0002-2736-0597

A. S. Aleksandrov, Zaporozhye Regional Clinical Hospital

Aleksandrov Artem - MD
Zaporizhzhia Regional Clinical Hospital
Orichivske str., 10, 69000, Zaporizhzhia, Ukraine
+38 (061) 228-03-77
artemdok@meta.ua
orcid.org/0000-0003-1069-8310

References

Ratto C, Campennì P, Papeo F, Donisi L, Litta F, Parello A. Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature. Tech Coloproctol. 2017 Dec;21(12):953-62. doi: 10.1007/s10151-017-1726-5. Epub 2017 Nov 24. Erratum in: Tech Coloproctol. 2018 Feb 28;: PMID: 29170839; PMCID: PMC5830492.

Xu L, Chen H, Lin G, Ge Q, Qi H, He X. Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials. Tech Coloproctol. 2016 Dec;20(12):825-33. doi: 10.1007/s10151-016-1551-2. Epub 2016 Nov 25. PMID: 27888438.

Trenti L, Biondo S, Galvez A, Bravo A, Cabrera J, Kreisler E. Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy versus conventional hemorrhoidectomy for grade III and IV hemorrhoids: postoperative morbidity and long-term outcomes. Tech Coloproctol. 2017 May;21(5):337-44. doi: 10.1007/s10151-017-1620-1. Epub 2017 Apr 27. Erratum in: Tech Coloproctol. 2018 Jun;22(6):479. PMID: 28451767.

Tsunoda A, Takahashi T, Kusanagi H. A prospective randomized trial of transanal hemorrhoidal dearterialization with mucopexy versus ultrasonic scalpel hemorrhoidectomy for grade III hemorrhoids. Tech Coloproctol. 2017 Aug;21(8):657-65. doi: 10.1007/s10151-017-1673-1. Epub 2017 Sep 4. PMID: 28871428.

De Nardi P, Capretti G, Corsaro A, Staudacher C. A prospective, randomized trial comparing the short- and long-term results of doppler-guided transanal hemorrhoid dearterialization with mucopexy versus excision hemorrhoidectomy for grade III hemorrhoids. Dis Colon Rectum. 2014 Mar;57(3):348-53. doi: 10.1097/DCR.0000000000000085. PMID: 24509458.

Denoya P, Tam J, Bergamaschi R. Hemorrhoidal dearterialization with mucopexy versus hemorrhoidectomy: 3-year follow-up assessment of a randomized controlled trial. Tech Coloproctol. 2014 Nov;18(11):1081-5. doi: 10.1007/s10151-014-1219-8. Epub 2014 Sep 24. PMID: 25248418; PMCID: PMC4246126.

Bjelanovic Z, Draskovic M, Veljovic M, Lekovic I, Karanikolas M, Stamenkovic D. Transanal hemorrhoid dearterialization is a safe and effective outpatient procedure for the treatment of hemorrhoidal disease. Cir Esp. 2016 Dec;94(10):588-94. English, Spanish. doi: 10.1016/j.ciresp.2016.07.002. Epub 2016 Oct 20. PMID: 27771095.

Shevtsov AM, Dukhovenko KK, Medvedyk YaYa, Shevchenko TA. Transanal haemorrhoidal dearterialization with laser ablation external hemorrhoids as a low-impact methods of solution of combined hemorrhoids in the outpatient setting. Shpytalna khirurgiya. Zhurnal im. L. Ya. Kovalchuka. 2016;(2):96-8. Ukrainian. doi: 10.11603/2414-4533.2016.2.6423.

Fatkhutdinov IM. Early complications after transanal of the hemorrhoids dezarterization with mucopexy and lifting the mucosa of the rectum in patients with iii and iv stage of hemorrhoidal disease and in patients with combined pathology of the anal canal. Vestnik sovremennoy klinicheskoy mediciny. 2016; 9(3), 59-61. Russian. doi: 10.20969/VSKM.2016.9(3).59-61.

Loganathan A, Das A, Luck A, Hewett P. Transanal haemorrhoidal dearterialization for the treatment of grade III and IV haemorrhoids: a 3-year experience. ANZ J Surg. 2016 Jan-Feb;86(1-2):59-62. doi: 10.1111/ans.12816. Epub 2014 Aug 21. PMID: 25142863.

Groshilin VS, Mirzoev LA, Shvetsov VK, Chernyshova EV. Efficacy of minimally invasive procedures in hemorrhoids treatment (grade II-III). Ulyanovskiy medico-biologicheskiy zhurnal. 2017;(2):95-103. Russian. doi 10.23648/UMBJ.2017.26.6223.

Atallah S, Maharaja GK, Martin-Perez B, Burke JP, Albert MR, Larach SW. Transanal hemorrhoidal dearterialization (THD): a safe procedure for the anticoagulated patient? Tech Coloproctol. 2016 Jul;20(7):461-6. doi: 10.1007/s10151-016-1481-z. Epub 2016 May 12. PMID: 27170327; PMCID: PMC4920854.

Infantino A, Bellomo R, Dal Monte PP, Salafia C, Tagariello C, Tonizzo CA, Spazzafumo L, Romano G, Altomare DF. Transanal haemorrhoidal artery echodoppler ligation and anopexy (THD) is effective for II and III degree haemorrhoids: a prospective multicentric study. Colorectal Dis. 2010 Aug;12(8):804-9. doi: 10.1111/j.1463-1318.2009.01915.x. PMID: 19508513.

Trenti L, Biondo S, Galvez A, Bravo A, Cabrera J, Kreisler E. Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy versus conventional hemorrhoidectomy for grade III and IV hemorrhoids: postoperative morbidity and long-term outcomes. Tech Coloproctol. 2017 May;21(5):337-344. doi: 10.1007/s10151-017-1620-1. Epub 2017 Apr 27. Erratum in: Tech Coloproctol. 2018 Jun;22(6):479. PMID: 28451767.

Breivik H, Borchgrevink PC, Allen SM, Rosseland LA, Romundstad L, Hals EK, Kvarstein G, Stubhaug A. Assessment of pain. Br J Anaesth. 2008 Jul;101(1):17-24. doi: 10.1093/bja/aen103. Epub 2008 May 16. PMID: 18487245.

Published
2020-12-28
How to Cite
Nykonenko, A. A., Okhrimenko, G. I., Haidarzhi, E. I., Golovko, N. G., Zubryk, I. V., Grushka, V. A., Gurov, T. V., & Aleksandrov, A. S. (2020). Transanal hemorrhoidal desarterization under ultrasound rectodopplerometry control in surgical treatment of hemorrhoids . Klinicheskaia Khirurgiia, 87(11-12), 62-66. https://doi.org/10.26779/2522-1396.2020.11-12.62
Section
General Problems of Surgery