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Hemorrhoids pp 1–10Cite as

Pros and Contras of Dearterialization of Hemorrhoids and Mucopexy

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Part of the book series: Coloproctology ((COLOPROCT))

Abstract

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.

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Authors and Affiliations

  1. Colorectal Surgery Division, Gastroenterology Department, Hospital das Clínicas, University of São Paulo, Rua Padre João Manoel, 222 Cj 120, São Paulo, São Paulo, 01420-002, Brazil

    Fábio Guilherme Campos

  2. Gastroenterology Department, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil

    Marleny Novaes Figueiredo

  3. Colorectal Surgery Division, University of Campinas, São Paulo, Brazil

    Carlos Augusto Real Martinez

Authors
  1. Fábio Guilherme Campos
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  2. Marleny Novaes Figueiredo
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  3. Carlos Augusto Real Martinez
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Corresponding author

Correspondence to Fábio Guilherme Campos .

Editor information

Editors and Affiliations

  1. Catholic University , Rome, Italy

    Carlo Ratto

  2. Catholic University, Rome, Catholic University, Rome , Rome, Italy

    Angelo Parello

  3. DepartofSurgicalSciences,ProctologyUnit, Catholic University DepartofSurgicalSciences,ProctologyUnit, Rome, Italy

    Francesco Litta

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Campos, F.G., Figueiredo, M.N., Martinez, C.A.R. (2017). Pros and Contras of Dearterialization of Hemorrhoids and Mucopexy. In: Ratto, C., Parello, A., Litta, F. (eds) Hemorrhoids. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-51989-0_38-1

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  • DOI: https://doi.org/10.1007/978-3-319-51989-0_38-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51989-0

  • Online ISBN: 978-3-319-51989-0

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