Long-term results of transanal hemorrhoidal dearterialization

Background: The transanal hemorrhoidal dearterialization (THD) combined with rectoanal repair (RAR) has firmly established itself in the practice. However, there are only few trials with long term results available. Methods: All patients who were treated with THD with RAR in the Department of General and Visceral Surgery of the Red Cross Hospital in Kassel between January 2009 and December 2012 were retrospectively examined using a standardized questionnaire mailed. Patient satisfaction was measured using the analog scale from 1 (least satisfied) to 10 (most satisfied). Results: After approval by the ethics committee, we were able to analyze the data of 85 patients. The mean follow-up was 54 months (ranging 28–76 months). 33 (39%) reported a recurrence of symptoms, 11 (13%) patients had to be operated again. There were no urinary retention and/or urinary incontinence reported. A change of stool behavior was observed in 20% of the cases, out of which 11% of the cases showed improvement. In other cases, a slight increase of constipation and incontinence was observed. No one has developed severe stool incontinence. The mean postoperative score of patient satisfaction was 7,7 in the total group and 6,9 in the group of patients with recurrent symptoms (not significant, p > 25). Conclusions: The THD combined with RAR is a safe and effective treatment for hemorrhoidal disease. © 2016, Springer Medizin Verlag Berlin.