Main Advantages of Dearterialization of Hemorrhoids and Mucopexy
Hemorrhoidal dearterialization with mucopexy is a minimally invasive method of treating hemorrhoidal disease which is effective for reducing the symptoms of hemorrhoids and improving quality of life. Moreover, it has the obvious advantages of preservation of the anatomy and physiology of the anal canal, absence of external wounds, better tolerance, and a less painful postoperative period, especially compared with hemorrhoidectomy, but also probably compared with stapled hemorrhoidopexy. It is therefore usually provided on a day surgery basis and scores better in terms of general activity and ability to return to social and/or work activities. The procedure is also safe, with low postoperative morbidity and few complications, which are usually minor.
There is a probable higher long-term risk of recurrence of prolapse and/or bleeding after hemorrhoidal dearterialization with mucopexy, particularly in comparison with hemorrhoidectomy, but it is not a real problem in a time when patients often prefer a risk-free procedure and a short-term benefit to a potential long-term disadvantage.
Conflict of Interest
NF, AB, EC, JDZ, FP: none.
VdP, EP, PB: payment for travel to surgical meeting
- De Nardi P, Capretti G, Corsaro A, Staudacher C (2014) 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 57:348–353CrossRefPubMedPubMedCentralGoogle Scholar
- Infantino A, Altomare DF, Bottini C, Bonanno M, Mancini S, THD Group of the SICCR (Italian Society of Colorectal Surgery), Yalti T, Giamundo P, Hoch J, El Gaddal A, Pagano C (2012) Prospective randomized multicentre study comparing stapler haemorrhoidopexy with Doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids. Colorectal Dis 14:205–211CrossRefPubMedPubMedCentralGoogle Scholar
- Khafagy W, El Nakeeb A, Fouda E, Omar W, Elhak NG, Farid M, Elshobaky M (2009) Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; post operative pain and anorectal manometric assessment. Hepatogastroenterology 56:1010–1015PubMedPubMedCentralGoogle Scholar
- Lehur PA, Didnée AS, Faucheron JL, Meurette G, Zerbib P, Siproudhis L, Vinson-Bonnet B, Dubois A, Casa C, Hardouin JB, Durand-Zaleski I, LigaLongo Study Group (2016) Cost-effectiveness of new surgical treatments for hemorrhoidal disease: a multicentre randomized controlled trial comparing transanal Doppler-guided hemorrhoidal artery ligation with mucopexy and circular stapled hemorrhoidopexy. Ann Surg 264:710–716CrossRefPubMedPubMedCentralGoogle Scholar