Our Summary

This study aimed to compare two methods of treating hemorrhoids: transanal hemorrhoidal dearterialization (THD) and stapled hemorrhoidectomy (SH). The researchers looked at various randomized control trials (RCTs) that compared these two methods. They found that there were no significant differences between the two methods in terms of total complications, postoperative pain, operative time, time in hospital, time before returning to work, and the rate of needing to be re-operated on. However, they did find that there was a significant difference in terms of bleeding, with THD having a higher rate. They also found that THD had a higher rate of recurrence in the short-term, but this was equal in the long-term. The study concluded that both methods are equally effective, but more research is needed, particularly into cost-effectiveness, patient satisfaction, and long-term recurrence rates.

FAQs

  1. What are the two methods of treating hemorrhoids compared in the study?
  2. Were there any significant differences found between transanal hemorrhoidal dearterialization (THD) and stapled hemorrhoidectomy (SH) in terms of complications, pain, and recovery time?
  3. What areas did the study suggest require more research in terms of hemorrhoid treatment?

Doctor’s Tip

A doctor might tell a patient undergoing a hemorrhoidectomy to expect some discomfort and pain following the procedure, but to follow their post-operative care instructions closely to help manage the pain and promote healing. They may also advise the patient to eat a high-fiber diet, stay hydrated, and avoid straining during bowel movements to help prevent future hemorrhoids. It’s important for the patient to communicate any concerns or unexpected symptoms with their doctor to ensure a successful recovery.

Suitable For

Patients who have severe hemorrhoids that do not respond to conservative treatments such as dietary changes, fiber supplements, and topical medications may be recommended for a hemorrhoidectomy. Other potential candidates for hemorrhoidectomy include those with large external hemorrhoids, thrombosed hemorrhoids, or internal hemorrhoids that have prolapsed and cannot be treated with less invasive methods. Additionally, patients with significant symptoms such as chronic pain, bleeding, and difficulty with bowel movements may also be candidates for a hemorrhoidectomy. Ultimately, the decision to undergo a hemorrhoidectomy should be made in consultation with a healthcare provider who can assess the individual patient’s specific condition and recommend the most appropriate treatment option.

Timeline

Before hemorrhoidectomy:

  • Patient experiences symptoms of hemorrhoids such as bleeding, itching, pain, and discomfort.
  • Patient consults with a healthcare provider who may recommend conservative treatments such as dietary changes, topical ointments, and sitz baths.
  • If conservative treatments are ineffective, the healthcare provider may recommend surgical intervention such as hemorrhoidectomy.
  • Patient undergoes preoperative evaluation and preparation for surgery.

After hemorrhoidectomy:

  • Patient undergoes the hemorrhoidectomy procedure, which may be performed using different techniques such as THD or SH.
  • Patient may experience postoperative pain, discomfort, and bleeding, which can be managed with pain medications and follow-up appointments with the healthcare provider.
  • Patient is discharged from the hospital and instructed on postoperative care including wound care, diet modifications, and activity restrictions.
  • Patient may experience improvements in symptoms such as bleeding and pain in the following weeks and months.
  • Patient follows up with the healthcare provider for postoperative evaluation and monitoring for complications or recurrence of hemorrhoids.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy include:

  1. What are the risks and potential complications associated with hemorrhoidectomy?
  2. How long is the recovery period after a hemorrhoidectomy?
  3. Will I need to take time off work or modify my activities during the recovery period?
  4. What type of anesthesia will be used during the procedure?
  5. How long will the procedure take?
  6. What are the chances of the hemorrhoids coming back after the surgery?
  7. Will I need to follow a special diet or take any medications after the procedure?
  8. What is the success rate of the procedure in terms of relieving symptoms?
  9. Are there any alternative treatments or procedures that I should consider?
  10. How often will I need to follow up with you after the surgery?

Reference

Authors: Song Y, Chen H, Yang F, Zeng Y, He Y, Huang H. Journal: Medicine (Baltimore). 2018 Jul;97(29):e11502. doi: 10.1097/MD.0000000000011502. PMID: 30024532