TRANSANAL HEMORRHOIDAL DEARTERIALIZATION VS CONVENTIONAL HEMORRHOIDECTOMY FOR SYMPTOMATIC HAEMORRHOIDS: A REGIONAL PERSPECTIVE FROM NORTHERN PAKISTAN

Abstract

Background: The prevalence of hemorrhoidal disease is very high all over the world. Although conventional hemorrhoidectomy is the gold standard for grades III and IV hemorrhoids, it is often accompanied by a high level of postoperative pain and prolonged recovery. As a minimally invasive and tissue-saving method, transanal hemorrhoidal dearterialization (THD) has been developed, and its short-month prognosis presented well.

Objective: To compare postoperative pain levels, recurrence rates, quality of life, and complication profiles between THD and CH in patients with symptomatic grade III and IV hemorrhoids.

Methods: This prospective comparative observational study was carried out at the department of general surgery, Hayatabad Medical Complex, Peshawar. A total of 148 patients were included. Pain was evaluated by the Visual Analogue Scale (VAS) at 24 hours, 7 days, and 30 days after surgery. Recurrence was analyzed at 3 months and quality of life was assessed with the SF-36 questionnaire preoperatively and postoperatively.

Results: Both groups had increases in the quality of life scores, which was higher in the mean increase among the THD group (22.3 ± 5.1 vs. 16.7 ± 4.6; p<0.001). Although there was a higher recurrence rate in the THD group (5.4%) compared to the CH (1.3%), it was not statistically significant (p=0.17). The overall complication rate was significantly less in the THD group (4.0% versus 14.8%; p=0.03).

Conclusion: THD provides a less painful recovery, less complications and a better quality of life in early stage than CH and should therefore be considered a valuable alternative for selected patients with advanced hemorrhoidal disease.