{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T04:01:37Z","timestamp":1768881697447,"version":"3.49.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Open excisional haemorrhoidectomy (OEH) remains the standard treatment for advanced haemorrhoidal disease, offering low recurrence but notable postoperative pain. Transanal haemorrhoidal dearterialization (THD) is an alternative with reduced pain but potentially higher recurrence. The aim of this trial was to compare the 1-year efficacy of both techniques using validated symptom and quality-of-life scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective, single-centre, randomized, open-label trial was conducted in patients with grade III haemorrhoids. The primary outcome was the relative change at 12\u2005months in Haemorrhoidal Disease Symptom Score (HDSS) and Short Health Scale adapted for Haemorrhoidal Disease (SHS-HD) from baseline. Additionally, the predefined, pragmatic composite endpoint\u2014the clinical failure rate (CFR), defined as a \u226450% improvement in both HDSS and SHS-HD\u2014was compared. Secondary outcomes included postoperative pain, time to return to work, complications, and reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From August 2021 to February 2023, 50 patients were randomized (25 OEH patients and 25 THD patients). Three patients were lost to follow-up (2 THD patients and 1 OEH patient). CFR was significantly higher in the THD group (14 of 23 (61%)) versus the OEH group (2 of 24 (8%)) (P &amp;lt;0.001). All eigth reoperations occurred in the THD group (P = 0.001). Both procedures reduced symptom and quality-of-life scores (P = 0.002 and P &amp;lt; 0.001). OEH was associated with greater early postoperative pain and a longer time to return to work (median of 21 versus 14\u2005days; P = 0.010).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OEH is more effective than THD but is associated with greater early postoperative pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration number<\/jats:title>\n                    <jats:p>NCT06420986 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjs\/znaf282","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:10:54Z","timestamp":1765545054000},"source":"Crossref","is-referenced-by-count":0,"title":["Open excisional haemorrhoidectomy\n                    <i>versus<\/i>\n                    transanal haemorrhoidal dearterialization for grade III haemorrhoids: open-label randomized clinical trial"],"prefix":"10.1093","volume":"113","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9363-3127","authenticated-orcid":false,"given":"Ignacio","family":"Fernandez-Hurtado","sequence":"first","affiliation":[{"name":"Department of Surgery, Hospital Son Ll\u00e0tzer , Mallorca ,","place":["Spain"]},{"name":"Health Research Institute of the Balearic Islands (IdISBa) , Mallorca, Balearic Islands ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0898-9303","authenticated-orcid":false,"given":"Naila","family":"Pages-Valle","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Son Ll\u00e0tzer , Mallorca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5869-7865","authenticated-orcid":false,"given":"Maria F","family":"Sarubbo","sequence":"additional","affiliation":[{"name":"Health Research Institute of the Balearic Islands (IdISBa) , Mallorca, Balearic Islands ,","place":["Spain"]},{"name":"Faculty of Science, University of the Balearic Islands , Mallorca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Claramonte-Bellmunt","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Son Ll\u00e0tzer , Mallorca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8399-2273","authenticated-orcid":false,"given":"Santiago","family":"Baena-Bradaschia","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Son Ll\u00e0tzer , Mallorca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4886-0176","authenticated-orcid":false,"given":"Jose A","family":"Cifuentes-Rodenas","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hospital Son Ll\u00e0tzer , Mallorca ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0291-1900","authenticated-orcid":false,"given":"Xavier","family":"Serra-Aracil","sequence":"additional","affiliation":[{"name":"Department of Surgery, Universitat Aut\u00f2noma Barcelona, Institut D\u2019Investigaci\u00f3 I Innovaci\u00f3 Parc Taul\u00ed I3PT-CERCA , Sabadell, Barcelona ,","place":["Spain"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"2026011910295019600_znaf282-B1","volume-title":"Surgery of the Anus, Rectum and Colon","author":"Goligher","year":"1980"},{"key":"2026011910295019600_znaf282-B2","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1016\/S0140-6736(00)88465-2","article-title":"Surgical anatomy of the anal canal, and the operative treatment of haemorrhoids","volume":"230","author":"Naunton Morgan","year":"1937","journal-title":"Lancet"},{"key":"2026011910295019600_znaf282-B3","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.1007\/s00384-021-04013-6","article-title":"Post-haemorrhoidectomy pain: can surgeons reduce it? 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