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Updated: May 3, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Transanal dearterialization with targeted mucopexy is effective for advanced haemorrhoids
P Giordano1, I Tomasi, A Pascariello
1Department of Colorectal Surgery, Barts Health, London, UK.
Aim:
Transanal haemorrhoidal dearterialization (THD) has become well established for the treatment of haemorrhoids. In this study we describe a technical modification of this technique, targeted mucopexy (THD TM), and report the results for advanced haemorrhoids.
Method:
The study included a prospective evaluation of patients with Grade IV (fourth-degree) haemorrhoids operated on with the THD TM 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.
Results:
From January 2007 to December 2011, 31 consecutive patients with Grade IV haemorrhoids were operated on using the THD TM 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-up of 32 months, two (6.4%) patients required a further intervention for on-going symptoms.
Conclusion:
Transanal haemorrhoidal dearterialization TM is effective for advanced haemorrhoids.
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