Randomized Controlled Trial Comparing Transanal Doppler-guided Arterial Ligation With Mucopexy and Stapled Haemorrhoidopexy

Cost-effectiveness of New Surgical Treatments for Haemorrhoidal Disease - Randomized Controlled Trial Comparing Transanal Doppler-guided Arterial Ligation With Mucopexy and Stapled Haemorrhoidopexy (Longo's Technique)

This multicentre RCT aims to compare two surgical treatments of haemorrhoidal disease: doppler-guided arterial ligation with mucopexy (DGALM) and stapled haemorrhoidopexy according to Longo (SH). The hypothesis of the trial is that the DGALM is at a lesser risk and is more cost-effective than SH. With a large number of patients managed in more than 20 centres, we aim to demonstrate that DGALM has a lower morbidity than SH when treating haemorrhoidal disease. At a lower postoperative risk and a lower risk of sequelae, the DGALM would demonstrate to be cost-effective for health care system and attractive for patients.

Inclusion Criteria:

• Patient (male or female) 18 - 75 y.o
• Suffering from symptomatic grade II or III haemorrhoidal disease (bleeding and/or prolapse)
• requiring surgery

Exclusion Criteria:

• Acute complication of haemorrhoidal disease
• History of anal surgery for haemorrhoids
• Congenital or acquirred anal stenosis
• Anal fissure or perianal abcess
• Inflammatory bowel disease
• Colon or rectal cancerv History of rectal or sigmoid resection
• Rectal prolapse
• Portal vein hypertension
• Haemophylia
• Pregnancy