Aim: The effectiveness of Doppler guided transanal haemorrhoidal dearterialization (THD) was studied in arresting persistent haemorrhoidal bleeding in patients admitted as an emergency. Method: Eleven patients with severe anal bleeding underwent emergency THD as definitive treatment for haemorrhoids. In the majority of patients antiplatelet or anticoagulant therapy was ongoing and severe anemia was present in six patients. Results: The mean operative time was 39.7 minutes. Six to nine feeding arteries were ligated. Intraoperative blood loss was nil. Bleeding was well controlled in all patients. No blood transfusion was required. Mean pain score per Verbal Numeric Scale (VNS) was 3.6 and 1.4 on day 1 and 3 respectively. The mean time to resumption of normal activities was 8 days. No major complications were experienced. Six months follow up demonstrated good control of haemorrhoidal disease. Conclusion: THD is effective in controlling acute haemorrhoidal bleeding with a low incidence of post-operative complications
Emergency transanal haemorrhoidal Doppler guided dearterialization (THD) for acute and persistent haemorrhoidal bleeding.
CAVAZZONI, Emanuel;BUGIANTELLA, WALTER;GRAZIOSI, LUIGINA;CANTARELLA, FRANCESCO;DONINI, Annibale
2013
Abstract
Aim: The effectiveness of Doppler guided transanal haemorrhoidal dearterialization (THD) was studied in arresting persistent haemorrhoidal bleeding in patients admitted as an emergency. Method: Eleven patients with severe anal bleeding underwent emergency THD as definitive treatment for haemorrhoids. In the majority of patients antiplatelet or anticoagulant therapy was ongoing and severe anemia was present in six patients. Results: The mean operative time was 39.7 minutes. Six to nine feeding arteries were ligated. Intraoperative blood loss was nil. Bleeding was well controlled in all patients. No blood transfusion was required. Mean pain score per Verbal Numeric Scale (VNS) was 3.6 and 1.4 on day 1 and 3 respectively. The mean time to resumption of normal activities was 8 days. No major complications were experienced. Six months follow up demonstrated good control of haemorrhoidal disease. Conclusion: THD is effective in controlling acute haemorrhoidal bleeding with a low incidence of post-operative complicationsI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
