{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:04:18Z","timestamp":1791648258563,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,12,23]],"date-time":"2014-12-23T00:00:00Z","timestamp":1419292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This multicentre study, based on the largest patient population ever published, aims to evaluate the efficacy of Doppler\u2010guided transanal haemorrhoidal dearterialization (<jats:styled-content style=\"fixed-case\">THD<\/jats:styled-content> Doppler) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid\u2010term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Eight hundred and three patients affected by Grade <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> (137, 17.1%), <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content> (548, 68.2%) and <jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content> (118, 14.7%) symptomatic haemorrhoidal disease underwent <jats:styled-content style=\"fixed-case\">THD<\/jats:styled-content> Doppler, with a rectal mucopexy in patients with haemorrhoidal prolapse. The disease was assessed through a specifically designed symptom questionnaire and scoring system. A uni\u2010 and multivariate analyses of the potential predictive factors for failure were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The morbidity rate was 18.0%, represented mainly by pain or tenesmus (106 patients, 13.0%). Acute bleeding requiring surgical haemostasis occurred in seven patients (0.9%). No serious or life\u2010threatening complications occurred. After a mean follow\u2010up period of 11.1\u00a0\u00b1\u00a09.2\u00a0months, the overall success rate was 90.7% (728 patients), with a recurrence of haemorrhoidal prolapse, bleeding, and both symptoms in 51 (6.3%), 19 (2.4%) and 5 (0.6%) patients, respectively. Sixteen out of 47 patients undergoing re\u2010operation had a conventional haemorrhoidectomy. All the symptoms were significantly improved in each domain of the score (<jats:italic>P\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.0001). At multivariate analysis the absence of morbidity and performance of a distal Doppler\u2010guided dearterialization were associated with a better outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">THD<\/jats:styled-content> Doppler is a safe and effective therapy for haemorrhoidal disease. If this technique is to be employed, an accurate distal Doppler\u2010guided dearterialization and a tailored mucopexy are mandatory to contain and reduce the symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12779","type":"journal-article","created":{"date-parts":[[2014,9,12]],"date-time":"2014-09-12T08:02:07Z","timestamp":1410508927000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":69,"title":["Doppler\u2010guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial"],"prefix":"10.1111","volume":"17","author":[{"given":"C.","family":"Ratto","sequence":"first","affiliation":[{"name":"Proctology Unit Department of Surgical Sciences Catholic University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Parello","sequence":"additional","affiliation":[{"name":"Proctology Unit Department of Surgical Sciences Catholic University Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Veronese","sequence":"additional","affiliation":[{"name":"Ospedale Fracastoro, San Bonifacio San Bonifacio Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Cudazzo","sequence":"additional","affiliation":[{"name":"Ospedale Civile di Guastalla Guastalla Reggio Emilia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"D'Agostino","sequence":"additional","affiliation":[{"name":"Presidio Ospedaliero San Sebastiano di Frascati Frascati Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Pagano","sequence":"additional","affiliation":[{"name":"A. 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