الفهرس 
Introduction and aim of the work
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Abstract
Background: There are different types of hemorrhoids and they produce variable symptoms. The types of hemorrhoids and their symptoms govern treatment. Transanal hemorrhoidal dearterialization is a new option for the management of patient who require an operative hemorrhoidectomy and whom there were contraindication to an operative hemorrhoidectomy. Objective: Comparative study between transanal hemorrhoidal dearterialization and conventional surgical methods as regarding improvement in preoperative symptoms and reduction of postoperative complications. Methods: This study was carried out on 40 patients suffering from hemorrhoids. Patients divided into two groups. Group I were subjected to Doppler guided hemorrhoidal dearterialization. Group II were subjected to conventional hemorrhoidectomy. Both groups were compared to each other regarding postoperative pain tolerance and required of analgesia as well as postoperative complications. Results: All patients were followed up in postoperative period with special concern about pain score comparing both Group I and Group II. There was remarkable difference in the pain score between the two groups, e.g., group I being much less pain score than Group II. Concerning type of analgesia, there was distinguish difference between Group I and Group II, Group I required less analgesia than Group II. Regarding discharge Group I should less incidence of postoperative discharge than Group II. In Group I no cases reported to develop stenosis compared to 2 cases in Group II. As regard recurrence there was no significant difference between both groups. Conclusion & Recommendations: Use of Doppler guided hemorrhoidal dearterialization in the treatment of hemorrhoids is safe, effective, cause minimal pain, and is associated with fewer complications than conventional hemorrhoidectomy. It may replace traditional surgery for treatment of hemorroids.