Trans-anal Hemorrhoidal Dearterialization (THD) vs. Hemorrhoidectomy

The THD technique involves using ultrasound equipment to identify the arteries that are
feeding blood into the hemorrhoids. Once located, stitches are placed around those arteries
to cut off the blood supply to the hemorrhoids, which destroys them.

In the standard surgical excision technique, the hemorrhoids are removed by cutting them out
with a scalpel.

Both techniques are widely used in many hospitals today. However, there have been no formal
studies comparing the two techniques regarding outcomes, particularly regarding pain after
the procedure. We plan to enroll 60 patients in this study here at Stony Brook; 30 patients
will have THD and 30 will have the standard surgical excision of hemorrhoids.

Inclusion Criteria:

Patients visiting colorectal outpatient office at Stony Book Medical Center, with the
diagnosis of 3rd or 4th degree hemorrhoids requiring hemorrhoidectomy will be invited to
participate in this study. The diagnosis of hemorrhoids will be established by a
colorectal surgeon based on following criteria:

1. physical exam

2. anoscopy or proctoscopy

Exclusion Criteria:

1. first and second degree hemorrhoids

2. recurrent hemorrhoids after previous surgical treatment

3. history of HIV

4. history of inflammatory bowel disease

5. inability to give informed consent due to mental disability

6. age younger than 18

7. history of colon, rectal or anal cancer

8. thrombosed hemorrhoids

9. pregnant women

10. non English speaking patients