Advances in Therapy

, Volume 36, Issue 6, pp 1388–1397 | Cite as

Comparison of Doppler-Guided Transanal Hemorrhoidal Dearterialization for Grade III and IV Hemorrhoids in Vietnam

  • Le Manh CuongEmail author
  • Tran Thu Ha
  • Nguyen Ngoc Anh
  • Nguyen Tien Thanh
  • Vu Duy Kien
  • Nguyen Duc Lam
Original Research



This study aimed to assess the short- and long-term outcomes of Doppler-guided transanal hemorrhoidal dearterialization (THD) for grade III and IV hemorrhoidal disease in Vietnam.


In a prospective observational design, patients treated for grade III and IV hemorrhoidal disease with the THD method at the National Hospital of Traditional Medicine (Hanoi, Vietnam) were included between June 2012 and December 2013. Patients were evaluated postoperatively at the time they were discharged from the hospital (short-term outcome) and 6 months after surgery (long-term outcome).


A total of 128 patients were enrolled in the study, 94 were classified with grade III disease and 34 with grade IV. Grade IV hemorrhoidal patients reported on average 18.2 years of disease symptom duration, while grade III hemorrhoidal patients reported 11.2 years. All patients with grade III and grade IV hemorrhoidal disease had good outcomes at discharge day and reported to return to work in a median of 6 days after THD. At long-term follow-up, the results were good for 80.9% of patients from grade III hemorrhoidal disease and 61.8% of patients from grade IV hemorrhoidal disease. Patient satisfaction with the procedure and outcomes was 93.6% for grade III and 85.3% for grade IV hemorrhoidal patients.


The THD technique was shown to be safe for both grade III and IV hemorrhoidal patients. The THD technique showed better results with grade III hemorrhoidal patients as compared to grade IV hemorrhoidal patients.


Dearterialization Doppler-guided THD Hemorrhoidal artery ligation Hemorrhoids Vietnam 



The authors thank patients and healthcare professionals who participated in this study.


No funding or sponsorship was received for this study or publication of this article. The article processing charges were funded by the authors.


All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.


The authors (Le Manh Cuong, Tran Thu Ha, Nguyen Ngoc Anh, Nguyen Tien Thanh, Vu Duy Kien and Nguyen Duc Lam) have nothing to disclose.

Compliance with Ethics Guidelines

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Military Medical University committee, Vietnam and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval to conduct the study was obtained from the committee of the Military Medical University, Vietnam by the Decision no. 2858/QD-HVQY. Informed consent was obtained from all individual participants included in the study.

Data Availability

The datasets generated during and/or analyzed during the current study are available in the Figshare repository,


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Copyright information

© Springer Healthcare Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Hospital of Traditional MedicineHanoiVietnam
  2. 2.Hanoi Medical UniversityHanoiVietnam
  3. 3.OnCare Medical Technology Company LimitedHanoiVietnam

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