{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:10:38Z","timestamp":1759936238418,"version":"3.41.2"},"reference-count":35,"publisher":"FapUNIFESP (SciELO)","issue":"2","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"abstract":"<jats:p>ABSTRACT  Background: Transanal haemorrhoidal dearterialization with mucopexy (THD-M) is a valuable option for treating patients with haemorrhoidal disease. However, there is still controversy with regard to its efficacy for more advanced grades.  Aim: To evaluate the effectiveness of THD-M technique for treating hemorrhoidal disease and to compare the immediate and late results in different grades.  Method: Seven hundred and five consecutive patients with Goligher\u2019s grade II, III or IV symptomatic haemorrhoids underwent surgical treatment using the THD-M method in five participating centres. Six well-trained and experienced surgeons operated on the patients. Average follow-up was 21 months (12-48).  Results: Intraoperative complications were observed in 1.1% of cases, including four cases of haematoma, two of laceration of the mucosa, and two of bleeding. All of these were controlled by means of haemostatic suturing. In relation to postoperative complications, the most common of these were as follows: transitory tenesmus (21.4%); pain (7.2%); mucosal or haemorrhoidal prolapse (6.4%); residual skin tag (5.6%); faecal impaction (3.2%); haemorrhoidal thrombosis (2.8%); bleeding (2.1%); anal fissure (0.7%); and anal abscess (0.3%). Most of the complications were treated conservatively, and only 7.5% (53\/705) required some type of surgical approach. There was no mortality or any severe complications. The recurrence of prolapse and bleeding was greater in patients with grade IV haemorrhoidal disease than in those with grade III and II (26.54% and 7.96% vs. 2.31% and 0.92% vs. 2.5% and 1.25%), respectively.   Conclusion: The THD-M method is safe and effective for haemorrhoidal disease grades II and III with low rates of surgical complications. However, for grade IV hemorrhoids, it is associated with higher recurrence of prolapse and bleeding. So, THD-M method should not be considered as an effective option for the treatment of grade IV hemorrhoids.<\/jats:p>","DOI":"10.1590\/0102-672020190001e1504","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T20:39:54Z","timestamp":1598301594000},"source":"Crossref","is-referenced-by-count":8,"title":["TRANSANAL HAEMORRHOIDAL DEARTERIALIZATION WITH MUCOPEXY (THD-M) FOR TREATMENT OF HEMORRHOIDS: IS IT APPLICABLE IN ALL GRADES? BRAZILIAN MULTICENTER STUDY"],"prefix":"10.1590","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4486-9894","authenticated-orcid":false,"given":"Carlos Walter","family":"SOBRADO","sequence":"first","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil; Hospital 9 de Julho,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4120-1047","authenticated-orcid":false,"given":"Sidney","family":"KLAJNER","sequence":"additional","affiliation":[{"name":"Albert Einstein Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0348-8972","authenticated-orcid":false,"given":"Jos\u00e9 Am\u00e9rico Bacchi","family":"HORA","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil; Hospital 9 de Julho,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8888-8312","authenticated-orcid":false,"given":"Anderson","family":"MELLO","sequence":"additional","affiliation":[{"name":"Dona Helena Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3527-0970","authenticated-orcid":false,"given":"Fabricio Marcondes Luciano da","family":"SILVA","sequence":"additional","affiliation":[{"name":"Military Hospital,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2096-9578","authenticated-orcid":false,"given":"Marcos Onofre","family":"FRUGIS","sequence":"additional","affiliation":[{"name":"Hospital 9 de Julho,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2336-5278","authenticated-orcid":false,"given":"Lucas Faraco","family":"SOBRADO","sequence":"additional","affiliation":[{"name":"University of S\u00e3o Paulo,  Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","published-online":{"date-parts":[[2020]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s10151-007-0376-4","article-title":"Transanal haemorrhoidal dearterialization nonexcisional surgery for the treatment of haemorrhoidal disease","volume":"11","author":"Dal Monte PP","year":"2007","journal-title":"Tech Coloproctol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1097\/DCR.0000000000000085","article-title":"A prospective randomized trial comparing the short and long-term results of Doppler-guided transanal hemorrhoid dearterialization with mucopexy versus excision hemorrhoidectomy for grade III hemorrhoids","volume":"57","author":"De Nardi P","year":"2014","journal-title":"Dis Colon Rectum"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1111\/codi.12303","article-title":"Dearterialization with mucopexy VS Haemorrhoidectomy for grade III or IVhaemorrhoids short-term results of a double-blind randomized controlled trial","volume":"15","author":"Denoya PI","year":"2013","journal-title":"Colorectal Dis"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1007\/DCR.0b013e318201d31c","article-title":"Doppler-guided hemorrhoidal artery ligation and rectoanal repair (HAL-RAR) for the treatment of grade IV hemorrhoids long-term results in 100 consecutive patients","volume":"54","author":"Faucheron JL","year":"2011","journal-title":"Dis Colon Rectum"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/j.cgh.2012.12.020","article-title":"The evaluation and treatment of hemorrhoids: a guide for the gastroenterologist","volume":"11","author":"Ganz RA","year":"2013","journal-title":"Clin Gastroenterol Hepatol"},{"issue":"1","key":"ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4240\/wjgs.v8.i1.1","article-title":"Advantages and limits of hemorrhoidal dearterialization in the treatment of symptomatic haemorrhoids","volume":"8","author":"Giamundo P","year":"2016","journal-title":"World J Gastrointest Surg"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1001\/archsurg.2008.591","article-title":"Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy a meta-analysis of randomized controlled trials","volume":"144","author":"Giordano P","year":"2009","journal-title":"Arch Surg"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1007\/DCR.0b013e3181af50f4","article-title":"Transanal hemorrhoidal dearterialization a systematic review","volume":"52","author":"Giordano P","year":"2009","journal-title":"Dis Colon 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A","year":"2010","journal-title":"Colorectal Dis"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/j.1463-1318.2011.02628.x","article-title":"Prospective randomized multicentre study comparing stapler haemorrhoidectomy with doppler-guided transanal haemorrhoid dearterialization for third-degree haemorrhoids","volume":"14","author":"Infantino A","year":"2012","journal-title":"Colorectal Dis"},{"issue":"6","key":"ref13","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3393\/jksc.2011.27.6.298","article-title":"One year follow-up result of Doppler-guided hemorrhoidal artery ligaton and recto-anal repair in 97 consecutive patients","volume":"27","author":"Jeong WJ","year":"2011","journal-title":"J Korean Soc Coloproctol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1016\/0016-5085(90)90828-O","article-title":"The prevalence of hemorrhoids and chronic constipation An epidemiological study","volume":"98","author":"Jhanson 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haemorrhoids results from a multicentre trial","volume":"17","author":"Ratto C","year":"2014","journal-title":"Colorectal Dis"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s10353-012-0182-8","article-title":"DG-RAR for the treatment of symptomatic grade III and grade IV haemorrhoids a 12-month multi-centre, prospective observational study","volume":"45","author":"Roka S","year":"2013","journal-title":"Eur Surg"},{"key":"ref30","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1007\/s00384-015-2148-3","article-title":"Doppler-guided hemorrhoidal artery ligation with hemorrhoidopexy source and prevention of postoperative pain","volume":"30","author":"Rubbini M","year":"2015","journal-title":"Int J Colorectal Dis"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10151-011-0796-z","article-title":"A systematic review comparing transanal dearterialization to stapled haemorrhoidopexy in the management of haemorrhoidal disease","volume":"16","author":"Sajid MS","year":"2012","journal-title":"Tech Coloproctol"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.amjsurg.2005.10.007","article-title":"Doppler-guided hemorrhoidal artery ligation","volume":"191","author":"Scheyer M","year":"2006","journal-title":"Am J Surg"},{"issue":"3","key":"ref33","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1590\/S0004-28032006000300016","article-title":"Initial experience with stapled hemorrhoidopexy for treatment of hemorrhoids","volume":"43","author":"Sobrado CW","year":"2006","journal-title":"Arq Gastroenterol"},{"key":"ref34","doi-asserted-by":"crossref","first-page":"S21","DOI":"10.1007\/s10151-011-0727-z","article-title":"Outcomes of Doppler-guided hemorrhoid artery ligation analysis of 90 consecutive patients","volume":"15","author":"Spyridakis M","year":"2011","journal-title":"Tech Coloproctol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.amjsurg.2012.01.014","article-title":"Long-term results and quality of life in patients treated with hemorrhoidectomy using two diferentes techniques ligasure versus transanal hemorrhoidal dearterialization","volume":"204","author":"Zampieri N","year":"2012","journal-title":"Am J Surg"}],"container-title":["ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S\u00e3o Paulo)"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/abcd\/v33n2\/0102-6720-abcd-33-02-e1504.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,24]],"date-time":"2021-01-24T00:35:39Z","timestamp":1611448539000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-67202020000200301&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020]]}},"alternative-id":["S0102-67202020000200301"],"URL":"https:\/\/doi.org\/10.1590\/0102-672020190001e1504","relation":{},"ISSN":["2317-6326","0102-6720"],"issn-type":[{"type":"electronic","value":"2317-6326"},{"type":"print","value":"0102-6720"}],"subject":[],"published":{"date-parts":[[2020]]},"article-number":"e1504"}}