Langzeitergebnisse der Hämorrhoidenbehandlung in Stadien 2 und 3 mittels THD (transanale Hämorrhoidendearterilisation) kombiniert mit Mukopexie.
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Philipps-Universität Marburg
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Abstract
Purpose
The THD (transanal haemorrhoidal dearterialization) combined with mucopexy has firmly established itself in the practice. However, there are only few trials with long term results available.
Methods
Between January 2009 and December 2012 were treated 129 consecutive patients in the Red Cross Hospital in Kassel using transanal haemorrhoidal dearterialization (THD) with rekto-anal repair (RAR). The sex distribution was 61% (n=79) males and 39% (n=50) females. The median age was 52 years. The long-term follow-up was performed using a standardized questionnaire mailed. This questionnaire has assessed effects of THD with RAR on recurrent, relapse symptoms, stool and micturition and continence, as well as the general patient satisfaction.
Results
After approval by the ethics committee, we were able to analyze the data of 85 patients. The mean follow-up was 54 months (ranging 28-76 months). 52 patients remained free of symptoms, 33 (39%) reported a recurrence of symptoms, 11 (13%) patients had to be operated again. There were no micturition behavior and urinary incontinence reported. 24 patients complained before the operation about the tendency to constipation and 16 on the incontinence, 12 of them complained about both defecation disorders. The CCCS (Cleveland clinic constipation-score) averaged 6 scores before the operation and 5 scores after the operation. The CCIS (Cleveland clinic incontinence score) amounted in average 3 scores before and 3 scores after the operation. A change of stool behavior was observed in 15 (20%) cases, 8 (11%) of them reported on positive changes of constipation symptoms. 2 reported on deterioration of constipation without deterioration of incontinence and 3 had a deterioration of both constipation and incontinence. In 3 cases a slight incontinence occurred. A visual analog scale was used to assess patient satisfaction, ranging from 0 (least satisfied) to 10 (most satisfied). The mean postoperative score was 7,7 in the total group of patients and 6,9 in the group of patients with recurrent symptoms.
Conclusions
The THD (transanal haemorrhoidal dearterialization) combined with mucopexy is a safe and effective treatment for haemorrhoidal disease. A further surgery was required in only 13% of cases, which proves a high level of patient satisfaction. A change of stool behavior was observed in 15 cases (20%), out of which eight (11%) showed improvement. In other cases the slight increase of constipation and incontinence was observed. No one has developed sever incontinence.
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Dates
Created: 2016Issued: 2016-05-25
Faculty
Medizin
Publisher
Philipps-Universität Marburg
Language
ger
Data types
DoctoralThesis
Keywords
MukopexieRecto Anal Repairhemorrhoidal artery ligationtransanal hemorrhoidal dearterializationHämorrhoidal Arterien LigaturTHDtransanale Hämorrhoidendearterilisation
DFG-subjects
Hämorrhoiden
DDC-Numbers
610
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Radzikhovskiy, Arkadiy: Langzeitergebnisse der Hämorrhoidenbehandlung in Stadien 2 und 3 mittels THD (transanale Hämorrhoidendearterilisation) kombiniert mit Mukopexie.. : Philipps-Universität Marburg 2016-05-25. DOI: https://doi.org/10.17192/z2016.0336.