Hemorrhoids pp 395-403 | Cite as

Pros and Contras of Dearterialization of Hemorrhoids and Mucopexy

  • Fábio Guilherme Campos
  • Marleny Novaes Figueiredo
  • Carlos Augusto Real Martinez
Reference work entry
Part of the Coloproctology book series (COLOPROCT, volume 2)


Management of hemorrhoidal disease is a tough task. First of all, because more than one surgical technique may be adequately indicated to manage different patients. Secondly, patients desire a good option associated with less postoperative pain, low morbidity, and good long-term results. In this setting, conventional excision of hemorrhoids is highly effective, besides being associated with postoperative pain and discomfort. For this reason, nonexcisional alternatives have been developed in order to reduce complications and to provide better postoperative recovery. To accomplish this aim, the Doppler-guided hemorrhoidal dearterialization with anopexy was been introduced into clinical practice with high expectations. This hope has been maintained mainly for the encouraging early results, and despite the possibility of late prolapse recurrence, especially in grade IV disease. Anatomical and clinical studies have demonstrated the THD efficacy in controlling symptoms and ameliorating quality of life. As it preserves anatomy, it causes no detrimental effect on the anorectal physiology, making functional disturbances mainly transitory and rarely observed. Consequently, this technique may be an excellent option for patients with previous anal surgery and defecatory problems, when an additional procedure might increment this risk and affect quality of life. Furthermore, the THD technique has not been associated with frequent postoperative morbidity, life-threatening complications nor severe sequelae.


Hemorrhoids Transanal hemorrhoidal dearterialization Surgical treatment Recurrence Stapled hemorrhoidopexy Hemorrhoidectomy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Fábio Guilherme Campos
    • 1
  • Marleny Novaes Figueiredo
    • 2
  • Carlos Augusto Real Martinez
    • 3
  1. 1.Colorectal Surgery Division, Gastroenterology DepartmentHospital das Clínicas, University of São PauloSão PauloBrazil
  2. 2.Gastroenterology DepartmentHospital das Clínicas, University of São PauloSão PauloBrazil
  3. 3.Colorectal Surgery DivisionUniversity of CampinasSão PauloBrazil

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