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A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique

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Abstract

Background

Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD).

Methods

Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD. Patient demographics, perioperative data, postoperative pain scores, recurrence and patient satisfaction scores were evaluated. Patients with acute thrombosed hemorrhoids, external hemorrhoids only, or other concomitant anal diseases were excluded.

Results

From January 2013 to December 2015, 80 patients were included in the study, 40 in each group. There were no significant differences between groups as regards demographic data, perioperative data and postoperative pain scores. The median symptom scores for bleeding and prolapse were significantly lower in the TST group at 1 year (bleeding 1 vs. 2, p = 0.001; prolapse 1 vs. 2, p = 0.025). There was significantly less recurrence requiring reintervention in the TST group (4/40 vs. 17/40, p = 0.001). Satisfaction was significantly greater after TST. The median satisfaction scores after TST and THD were 4 and 3 (on a scale of 1–4; 4 = excellent satisfaction) (p < 0.00001), respectively.

Conclusions

Both THD and TST are safe, and they appear to have similar short-term outcomes; however, TST is associated with better improvement in symptoms, lower recurrence rates and greater patient satisfaction.

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Authors and Affiliations

  1. Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, People’s Republic of China

    A. L. H. Leung, T. P. P. Cheung, K. Tung, Y. P. Tsang, H. Cheung, C. W. Lau & C. N. Tang

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  1. A. L. H. Leung
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  2. T. P. P. Cheung
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Correspondence to A. L. H. Leung.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Hong Kong East Cluster Research Ethics Committee of the Hospital Authority.

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Informed consent was obtained from every patient.

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Leung, A.L.H., Cheung, T.P.P., Tung, K. et al. A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique. Tech Coloproctol 21, 737–743 (2017). https://doi.org/10.1007/s10151-017-1669-x

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  • DOI: https://doi.org/10.1007/s10151-017-1669-x

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