Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Ferguson Hemorrhoidectomy for Prolapsed Internal Hemorrhoids A Multicenter Prospective Study
Author Type(s)
Faculty, Resident/Fellow
Document Type
Abstract
Publication Date
9-2023
DOI
10.1097/SLA.0000000000005961
Journal Title
Annals of Surgery
Department
Surgery
Abstract
PAPERS OF THE 143RD ASA ANNUAL MEETING
Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Ferguson Hemorrhoidectomy for Prolapsed Internal Hemorrhoids
A Multicenter Prospective Study
Gachabayov, Mahir MD*; Angelos, George MD†; Orangio, Guy MD‡; Abcarian, Herand MD§; Bergamaschi, Roberto MD, PhD*; Hemorrhoids Study Group
CollaboratorsAuthor Information Annals of Surgery 278(3):p 376-382, September 2023. | DOI: 10.1097/SLA.0000000000005961
- BUY
- SDC
Metrics
Abstract
Objective:
To compare transanal hemorrhoidal dearterialization (THD) with mucopexy to Ferguson hemorrhoidectomy in terms of recurrence rates and quality of life.
Background:
There is uncertainty regarding the durability of the therapeutic effect of THD with mucopexy compared with Ferguson hemorrhoidectomy in terms of recurrence rates.
Methods:
This was a multicenter prospective study. Participating surgeons performed the operation they knew best enrolling 10 patients each. Surgeons’ unedited videos were reviewed by an independent expert. Patients with prolapsed internal hemorrhoids in at least 3 columns were eligible. The primary endpoint was recurrence rates defined as prolapsing internal hemorrhoids. Patient-reported outcomes and satisfaction were evaluated with Pain Scale and Brief Pain Inventory, Fecal Incontinence Quality Of Life (FIQOL), Cleveland Clinic Incontinence, Constipation, Short-Form 12 scores, and Patient satisfaction (4-point Likert) scale.
Results:
Twenty surgeons enrolled 197 patients. THD patients had lower Visual pain scores at postoperative day (POD) 1 (6.2 vs 8.3, P=0.047), POD7 (4.5 vs 7.7, P=0.021), POD14 (2.8 vs 5.3, P<0.001), and medication use at POD14 (23% vs 58%, P<0.001). Median follow-up was 3.1 (1.0–5.5) years. Recurrence rates did not differ between the study arms (5.9% vs 2.4%, P=0.253). Patient satisfaction rate was higher after THD at POD14 (76.4% vs 52.5%, P=0.031) and 3 months (95.1% vs 63.3%, P=0.029), but did not differ at 6 months (91.7% vs 88%, P=0.228) and 1 year (94.2% vs 88%, P=0.836).
Conclusion:
THD with mucopexy was associated with improved patient-reported outcomes and quality of life as compared with Ferguson hemorrhoidectomy with nonsignificantly different recurrence rates.
Recommended Citation
Gachabayov, M., Angelos, G., Orangio, G., Abcarian, H., Bergamaschi, R., & Hemorrhoids Study Group. (2023). Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Ferguson Hemorrhoidectomy for Prolapsed Internal Hemorrhoids A Multicenter Prospective Study. Annals of Surgery, 278 (3), 376-382. https://doi.org/10.1097/SLA.0000000000005961