{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T21:28:27Z","timestamp":1788125307553,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2013,10,24]],"date-time":"2013-10-24T00:00:00Z","timestamp":1382572800000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>There is scepticism regarding anatomical rationale and Doppler guidance for ligation of haemorrhoidal arteries. The null hypothesis of this randomized controlled trial (<jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>) was that there is no difference in pain following dearterialization or haemorrhoidectomy for grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> internal haemorrhoids in a minimum of three quadrants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a single\u2010centre, double\u2010blind <jats:styled-content style=\"fixed-case\">RCT<\/jats:styled-content>. Patients were allocated to dearterialization or haemorrhoidectomy. Included haemorrhoids were grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>, prolapsing but reducible; and grade <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>, chronic non\u2010incarcerated. The primary end\u2010point was pain. Patients with external component, acute incarcerated grade <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> or recurrent haemorrhoids were not included. The interventions were dearterialization (with <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>oppler guidance and mucopexy) or haemorrhoidectomy. The main outcome measure was the <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>rief <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>ain <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>nventory (<jats:styled-content style=\"fixed-case\">BPI<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty dearterialization patients were comparable to 20 haemorrhoidectomy patients for age (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.107), body mass index (<jats:italic>P<\/jats:italic> = 0.559), race (<jats:italic>P<\/jats:italic> = 0.437), American Society of Anesthesiology score (<jats:italic>P<\/jats:italic> = 0.569), comorbidities (<jats:italic>P<\/jats:italic> = 0.592), grade (<jats:italic>P<\/jats:italic> = 0.096), quadrants (<jats:italic>P<\/jats:italic> = 0.222), <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ecal <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>ncontinence <jats:styled-content style=\"fixed-case\">Q<\/jats:styled-content>uality\u2010of\u2010<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>ife <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>core (<jats:styled-content style=\"fixed-case\">FIQOL<\/jats:styled-content>;<jats:italic> P<\/jats:italic> = 0.388), coping (<jats:italic>P<\/jats:italic> = 0.532), depression (<jats:italic>P<\/jats:italic> = 0.505), embarrassment (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.842), and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>hort <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>orm <jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>ealth <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>urvey (<jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201012) physical components (<jats:italic>P<\/jats:italic> = 0.337), <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201012 mental components (<jats:italic>P<\/jats:italic> = 0.396) and constipation (<jats:italic>P<\/jats:italic> = 0.628) scores. Dearterialization patients had shorter operative time (36 <jats:italic>vs<\/jats:italic> 54 min, <jats:italic>P<\/jats:italic> = 0.043) with less pain (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.011) and urinary retention (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.012). Dearterialization patients had first bowel movement earlier (1.3 <jats:italic>vs<\/jats:italic> 4.6 days, <jats:italic>P<\/jats:italic> = 0.001), less pain (<jats:italic>P<\/jats:italic> = 0.011) and lower pain intensity (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001). Narcotic requirements were reduced in dearterialization patients (25% <jats:italic>vs<\/jats:italic> 100%, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001), with less medication (4.9 <jats:italic>vs<\/jats:italic> 112 pills, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001) and shorter regimen (0 <jats:italic>vs<\/jats:italic> 7\u00a0days, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001). <jats:styled-content style=\"fixed-case\">BPI<\/jats:styled-content> did not differ on days 1, 3, 5, 7 and 14 except for less pain in dearterialization patients. At 3\u00a0months, symptomatic relief was the same with no differences in <jats:styled-content style=\"fixed-case\">BPI<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> FIQOL<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">SF<\/jats:styled-content>\u201012.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Compared with haemorrhoidectomy, dearterialization led to less pain in grade <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> haemorrhoids.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12303","type":"journal-article","created":{"date-parts":[[2013,5,25]],"date-time":"2013-05-25T15:36:52Z","timestamp":1369496212000},"page":"1281-1288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Dearterialization with mucopexy <i>versus<\/i> haemorrhoidectomy for grade <scp>III<\/scp> or <scp>IV<\/scp> haemorrhoids: short\u2010term results of a double\u2010blind randomized controlled trial"],"prefix":"10.1111","volume":"15","author":[{"given":"P. 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