Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .
Doppler-guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial.
AIM This multicentre study , based on the largest patient population ever published , aims to evaluate the efficacy of Doppler-guided transanal haemorrhoidal dearterialization ( THD Doppler ) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid-term outcome . METHOD Eight hundred and three patients affected by Grade II ( 137 , 17.1 % ) , III ( 548 , 68.2 % ) and IV ( 118 , 14.7 % ) symptomatic haemorrhoidal disease underwent THD Doppler , with a rectal mucopexy in patients with haemorrhoidal prolapse . The disease was assessed through a specifically design ed symptom question naire and scoring system . A uni- and multivariate analyses of the potential predictive factors for failure were performed . RESULTS The morbidity rate was 18.0 % , represented mainly by pain or tenesmus ( 106 patients , 13.0 % ) . Acute bleeding requiring surgical haemostasis occurred in seven patients ( 0.9 % ) . No serious or life-threatening complications occurred . After a mean follow-up period of 11.1 ± 9.2 months , the overall success rate was 90.7 % ( 728 patients ) , with a recurrence of haemorrhoidal prolapse , bleeding , and both symptoms in 51 ( 6.3 % ) , 19 ( 2.4 % ) and 5 ( 0.6 % ) patients , respectively . Sixteen out of 47 patients undergoing re-operation had a conventional haemorrhoidectomy . All the symptoms were significantly improved in each domain of the score ( P < 0.0001 ) . At multivariate analysis the absence of morbidity and performance of a distal Doppler-guided dearterialization were associated with a better outcome . CONCLUSION THD Doppler is a safe and effective therapy for haemorrhoidal disease . If this technique is to be employed , an accurate distal Doppler-guided dearterialization and a tailored mucopexy are m and atory to contain and reduce the symptoms
Scores values tended to decrease postoperatively .
The comparison between haemorrhoidal treatments is still unclear .
Attempts have been made to adopt a unifying postoperative scoring system and thus ensure adequate comparison between clinical trials .
We aim ed to systematic ally review the available outcome scores of haemorrhoidal treatment .