Hybrid Vs Pure Hemorrhoidal Artery Ligation for the Treatment of Hemorrhoids: A Retrospective Study

Abstract

Purpose: Hemorrhoids are a common etiology of anal discomfort affecting up to half of the population. Treatment of hemorrhoids is variable; the choice of treatment is dependent on their grading. Surgical excision via conventional hemorrhoidectomy (CH) remains the gold standard treatment for high grade hemorrhoids. Transanal hemorrhoidal dearterialization (THD) is a less painful alternative to CH but associated with higher recurrence rates. A hybrid procedure has been recently adopted at the American University of Beirut Medical Center (AUBMC) in which hemorrhoidal artery ligation and conventional hemorrhoidectomy are combined. The aim of this study was to compare the recurrence rate between the pure hemorrhoid artery ligation procedure and the hybrid procedure as treatment modalities for hemorrhoids. Methods: A retrospective study was done at AUBMC comparing patients who underwent the hybrid procedures with those who underwent the pure THD. The patients were followed up to 5 years with a mean follow up of 6 months. Results: Our results showed that the hybrid procedure was associated with a lower recurrence rate than the pure procedure (5.7% Vs 13 %, p-value 0.155). In addition, the hybrid group has a lower rate of complications. Conclusion: The hybrid procedure comprises a novel technique for the treatment of hemorrhoids. It provides a safe alternative with lower complications rate compared to the pure procedure. Moreover, it provides a recurrence rate comparable to conventional hemorrhoidectomy with decreased postoperative pain.