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THD and mucopexy: Efficacy and controversy.

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Summary

Transanal haemorrhoidal dearterialisation and mucopexy (THD) is a safe, minimally invasive option for prolapsing haemorrhoids. Long-term follow-up shows acceptable outcomes, though a 13% recurrence rate may require repeat procedures.

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Area of Science:

  • Colorectal surgery
  • Minimally invasive procedures
  • Gastroenterology

Background:

  • Transanal haemorrhoidal dearterialisation and mucopexy (THD) is a popular, minimally invasive, non-excisional surgical technique for symptomatic prolapsing haemorrhoids.
  • The long-term efficacy and outcomes of THD-mucopexy require further investigation.

Purpose of the Study:

  • To analyze the long-term outcomes of Transanal haemorrhoidal dearterialisation and mucopexy (THD-mucopexy) in managing prolapsing haemorrhoids.
  • To evaluate complication rates and long-term recurrence based on prospective data from a single institution.

Main Methods:

  • Prospective data collection from 100 consecutive patients with grade 3 and 4 symptomatic haemorrhoids undergoing THD-mucopexy.
  • Procedures performed as day cases under general anaesthesia with a median follow-up of two years.
  • Assessment of pre- and postoperative symptoms, complications, and recurrence rates.

Main Results:

  • The study included 100 patients (61% male, 39% female) with an average age of 54.4 years.
  • Data from a prospective, single-institution study were analyzed.
  • [Table: see text]

Conclusions:

  • Transanal haemorrhoidal dearterialisation and mucopexy (THD-mucopexy) is a safe and effective minimally invasive treatment for symptomatic prolapsing haemorrhoids.
  • The procedure has acceptable complication rates and a 13% recurrence rate, with most cases manageable by repeat procedures.
  • Further long-term follow-up and randomized multicenter trials comparing THD-mucopexy with conventional excisional surgery are warranted.