{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T13:40:35Z","timestamp":1790516435851,"version":"4.1.0"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,4,12]],"date-time":"2014-04-12T00:00:00Z","timestamp":1397260800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Transanal haemorrhoidal dearterialization (<jats:styled-content style=\"fixed-case\">THD<\/jats:styled-content>) has become well established for the treatment of haemorrhoids. In this study we describe a technical modification of this technique, targeted mucopexy (<jats:styled-content style=\"fixed-case\">THD TM<\/jats:styled-content>), and report the results for advanced haemorrhoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The study included a prospective evaluation of patients with Grade <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> (fourth\u2010degree) haemorrhoids operated on with the <jats:styled-content style=\"fixed-case\">THD TM<\/jats:styled-content> technique. This consisted of an initial dearterialization when the haemorrhoidal arteries were transfixed and a second phase of mucopexy, using a different needle from that usually used in the original technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From January 2007 to December 2011, 31 consecutive patients with Grade <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> haemorrhoids were operated on using the <jats:styled-content style=\"fixed-case\">THD TM<\/jats:styled-content> technique. Postoperative pain was reported by 22 (70%) patients on day 1 and 19 (61%) on day 7, while nine (30%) did not experience any pain at all. Severe pain was reported by only nine (16%) patients. At a mean follow\u2010up of 32\u00a0months, two (6.4%) patients required a further intervention for on\u2010going symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transanal haemorrhoidal dearterialization <jats:styled-content style=\"fixed-case\">TM<\/jats:styled-content> is effective for advanced haemorrhoids.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12574","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T05:46:36Z","timestamp":1390801596000},"page":"373-376","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":53,"title":["Transanal dearterialization with targeted mucopexy is effective for advanced haemorrhoids"],"prefix":"10.1111","volume":"16","author":[{"given":"P.","family":"Giordano","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Barts Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Tomasi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Barts Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Pascariello","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Barts Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Barts Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Elahi","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Barts Health London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,4,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181af50f4"},{"key":"e_1_2_7_3_1","unstructured":"NICE Interventional Procedure Guidance 342 N2155 12 May 10.http:\/\/www.nice.org.uk\/nicemedia\/live\/12236\/48673\/48673.pdf"},{"key":"e_1_2_7_4_1","first-page":"610","article-title":"A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter","volume":"90","author":"Morinaga K","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(01)00759-0"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12303"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151-010-0667-z"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2011.02628.x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2008.591"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0861-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2005.10.007"},{"key":"e_1_2_7_12_1","first-page":"1010","article-title":"Conventional haemorrhoidectomy, stapled haemorrhoidectomy, Doppler guided haemorrhoidectomy artery ligation; 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