Comparative analysis of long-term results of hemorrhoidectomy and transanal dearterialization in stage II-IV hemorrhoids
DOI:
https://doi.org/10.11603/2414-4533.2026.2.16154Keywords:
hemorrhoids, hemorrhoidectomy, THD, transanal dearterialization, Wexner scale, quality of life, long-term resultsAbstract
The aim of the work: to evaluate and compare the 5-year follow-up results of two groups of patients with stage II–IV hemorrhoids: after conducted transanal hemorrhoidal dearterialization (THD) and hemorrhoidectomy using electro-generating equipment (EGE).
Materials and Methods. The treatment results of 144 patients divided into two groups were analyzed: Group 1 – THD (n=73) and Group 2 – hemorrhoidectomy (n=71). The groups were comparable in terms of gender and age (p>0.05). Data assessment was performed on days 1, 3, 10, and 30, as well as 1, 3, and 5 years postoperatively. A comprehensive examination of the patients was conducted, including anoscopy and proctoscopy. Evaluation tools included the Visual Analog Scale (VAS) for pain, the Wexner Incontinence Scale, and the SF-36 Quality of Life Questionnaire. Additionally, patient satisfaction with the treatment outcomes was assessed.
Results. In the early period (1-10 days), the intensity of pain in the group after transanal hemorrhoidal dearterialization was significantly lower (p˂0.001). However, after 5 years, the frequency of recurrences (prolapse) in the THD group was 13.5 % versus 3.4 % in the hemorrhoidectomy group (p˂0.01). At the same time, the group after transanal hemorrhoidal dearterialization showed a significant advantage in preserving sphincter function: the average score on the Wexner scale after 5 years was 0.2±0.1 versus 2.4±1.2 in the group with conducted EGE (p˂0.05). Cases of anal stenosis (5.2 %) were observed only after radical removal of the nodes. Despite the higher risk of recurrence at stage IV, the overall quality of life indicators (SF-36) were higher in the THD group.
Conclusions. Hemorrhoidectomy using electro generating equipment is a more radical method, gives reliable results even in stage IV hemorrhoids, but is associated with the risk of functional disorders and stenosis. The THD method provides rapid rehabilitation and better preservation of the function of the anal canal, is a priority for use for patients with stage II–III of the disease, focused on a high quality of life.
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