901 Transanal Hemorrhoidal Dearterialization vs Ferguson Hemorrhoidectomy in the Treatment of Hemorrhoidal Disease

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain. Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy. Method: From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5 %). Results: No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%). Conclusion: Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

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Scoring System for Haemorrhoidal Disease

Reviews on Recent Clinical Trials ◽

10.2174/1574887115666200319162033 ◽

2020 ◽

Vol 15 ◽

Cited By ~ 2

Author(s):

Francesco Maria Romano ◽

Guido Sciaudone ◽

Silvestro Canonico ◽

Francesco Selvaggi ◽

Gianluca Pellino

Keyword(s):

General Population ◽

Scoring System ◽

Careful Consideration ◽

Hemorrhoidal Disease ◽

Single System ◽

Haemorrhoidal Disease ◽

Definition Of

: Hemorrhoidal Disease (HD) is widely diffused throughout the general population. The system of classification currently used to categorize this pathology is that of Goligher (1975). This system only defines the morphology of the most represented hemorrhoid bearing. Several attempts in literature have been made to replace this system, but as of yet, no single system has been universally accepted. Some studies, however, have succeeded in identifying specific characteristics, besides morphology, that would be able to aptly define HD. An analysis of this literature, with careful consideration of the scores that have previously been proposed, is necessary in order to deepen and stimulate discussion about a possible new definition of HD.

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Transanal hemorrhoidal dearterialization (THD) for hemorrhoidal disease: a single-center study on 1000 consecutive cases and a review of the literature

Techniques in Coloproctology ◽

10.1007/s10151-017-1726-5 ◽

2017 ◽

Vol 21 (12) ◽

pp. 953-962 ◽

Cited By ~ 23

Author(s):

Carlo Ratto ◽

Paola Campennì ◽

Francesco Papeo ◽

Lorenza Donisi ◽

Francesco Litta ◽

...

Keyword(s):

Hemorrhoidal Disease ◽

Review Of The Literature ◽

Single Center ◽

Single Center Study ◽

Center Study

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Comparison of electrotherapy of hemorrhoids and Ferguson hemorrhoidectomy in a randomized prospective study

International Journal of Surgery ◽

10.1016/j.ijsu.2005.09.002 ◽

2005 ◽

Vol 3 (4) ◽

pp. 258-262 ◽

Cited By ~ 5

Author(s):

Ahmad Izadpanah ◽

Seyed Vahid Hosseini

Keyword(s):

Prospective Study ◽

Ferguson Hemorrhoidectomy

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Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease

The Scientific World JOURNAL ◽

10.1100/2012/324040 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Piotr Walega ◽

Michal Romaniszyn ◽

Jakub Kenig ◽

Roman Herman ◽

Wojciech Nowak

Keyword(s):

Safety Assessment ◽

Mucosal Prolapse ◽

Hemorrhoidal Disease ◽

Functional Evaluation ◽

Artery Ligation ◽

Major Complications ◽

Hemorrhoidal Artery Ligation ◽

Hemorrhoidal Artery ◽

Invasive Method ◽

Grade Iii

Purpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL) called Recto-Anal-Repair (RAR) in treatment of advanced hemorrhoidal disease (HD).Methods: Patients with grade III and IV HD underwent the RAR procedure (DGHAL combined with restoration of prolapsed hemorrhoids to their anatomical position with longitudinal sutures). Each patient had rectal examination, anorectal manometry, and QoL questionnaire performed before 3 months, and 12 months after RAR procedure.Results: 20 patients completed 12-month followup. There were no major complications. 3 months after RAR, 5 cases of residual mucosal prolapse were detected (25%), while only 3 patients (15%) reported persistence of symptoms. 12 months after RAR, another 3 HD recurrences were detected, to a total of 8 patients (40%) with HD recurrence. Anal pressures after RAR were significantly lower than before (P<0.05), and the effect was persistent 12 months after RAR. One patient (5%) reported occasional soiling 3 months after RAR.Conclusions: RAR seems to be a safe method of treatment of advanced HD with no major complications. The procedure has a significant influence on anal pressures, with no evidence of risk of fecal incontinence after the operation.

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