Abstract

Background and Objectives: A number of published studies comparing transanal haemorrhoidal dearterialization (THD) and conventional haemorrhoidectomy (CH) have primarily focused on short-term outcomes, while data on long-term results remains scarce. This study aimed to compare Doppler-guided THD and CH with emphasis on both early and long-term postoperative results. Methods: This retrospective study included 336 patients who underwent CH (Group 1, n = 189) or Doppler-guided THD (Group 2, n = 147). The groups were compared according to demographic data, HD stage, symptoms, complications, duration of hospital stay, postoperative pain, patient satisfaction, and recurrence rates after 18 months of surgery. Results: There was no difference between groups regarding gender, although there were statistically significant distinctions in terms of disease stage and age (p < 0.001), with the emphasis that in CH group patients had advanced stage of disease and were older. THD was associated with significantly lower postoperative pain, with median visual analogue scale (VAS) scores on postoperative days 1, 2, and 7 of 5, 3, and 1, compared with 7, 5, and 3 after CH (p < 0.001). There was no difference in VAS on POD 30 between groups. Median hospital stay was significantly shorter after THD (1 vs. 3 days; p < 0.001). Patients undergoing CH required more analgesics, laxatives, and follow-up visits within the first postoperative month (p ≤ 0.008). Postoperative complications occurred in nine patients, without significant differences between groups. During the 18-month follow-up period, HD recurrence occurred in seven patients and was more frequent after THD. Additionally, two THD patients developed anal fissures. Conclusions: Doppler-guided THD is a safe and effective treatment for HD, providing reduced postoperative pain, faster recovery, and shorter hospitalization. Long-term outcomes were favourable in both groups, with a trend of lower recurrence rate in the CH group.

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