Limited success in patients treated with transanal haemorrhoidal dearterialisation

Transanal haemorrhoidal dearterialisation (THD) is a novel non-excisional technique based on suture closure of the haemorrhoidal arterial flow feeding the haemorrhoidal plexus. The primary objective of this study was to report the first Danish experience with THD.

The study was a single-centre, non-controlled retrospective study that comprised consecutive patients from a two-year period. Prior to the study start, THD was introduced in our surgical department as the standard treatment of Grade III-IV haemorrhoids. All patients were clinically examined 4-6 weeks post-operatively. Additionally, a structured telephone interview was conducted within two years after the THD operation.

During the study period (from January 2011 to January 2013), 93 patients underwent a THD procedure. Twenty patients were exluded from the study which left 73 patients for analysis. Treatment success was obtained in 47 patients (64%) after a median follow-up period of nine months (range 1-24 months).

We found a relatively low success rate of 64% in patients undergoing THD. Our findings may, in part, reflect a learning curve, patient selection, or that a low success rate is associated with the use of THD per se.

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