Cost-Effectiveness of New Surgical Treatments for Hemorrhoidal Disease

A Multicentre Randomized Controlled Trial Comparing Transanal Doppler-Guided Hemorrhoidal Artery Ligation With Mucopexy and Circular Stapled Hemorrhoidopexy

Paul A. Lehur, MD, PhD; Anne S. Didnée, MD; Jean-Luc Faucheron, MD, PhD; Guillaume Meurette, MD, PhD; Philippe Zerbib, MD, PhD; Laurent Siproudhis, MD, PhD; Béatrice Vinson-Bonnet, MD; Anne Dubois, MD; Christine Casa, MD; Jean-Benoit Hardouin, PhD; Isabelle Durand-Zaleski, MD, PhD


Annals of Surgery. 2016;264(5):710-716. 

In This Article


In this RCT, we report that both DGHAL and SH are viable, safe, and effective treatments for GII to GIII HD, confirming results of other studies.[25] Postoperative outcomes slightly favor DGHAL. However, a superior anatomical correction associated with only a marginal increase in pain and no additional morbidity make SH a suitable surgical treatment option for GIII symptomatic hemorrhoids. Conversely, the DGHAL shorter postoperative recovery and lower pain would be appealing for patients especialy GII HD informed of the potential risk of incomplete success and recurrence.

Cost analysis showed SH to be cheaper than DGHAL. To be cost-effective compared with SH, DGHAL has to take less than 35 minutes and be performed with outpatients, an achievable goal according to literature.