Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up

2008 ◽  
Vol 22 (11) ◽  
pp. 2379-2383 ◽  
Author(s):  
Piotr Wałęga ◽  
Mathias Scheyer ◽  
Jakub Kenig ◽  
Roman M. Herman ◽  
Steffen Arnold ◽  
...  
Keyword(s):  
Functional Results ◽  
Hemorrhoidal Disease ◽  
Artery Ligation ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery

scholarly journals Hybrid digitally guided hemorrhoidal artery ligation with laser hemorrhoidoplasty: our experience with a new approach to hemorrhoidal disease

2021 ◽  
Vol 8 (10) ◽  
pp. 2968
Author(s):  
Anushtup De ◽  
Prabal Roy
Keyword(s):  
Postoperative Pain ◽  
Recurrence Rate ◽  
Postoperative Bleeding ◽  
Hemorrhoidal Disease ◽  
Artery Ligation ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
Grade Ii ◽  
Suspected Recurrence

Background: Minimally invasive surgeries are currently advocated in hemorrhoidal disease for better patient satisfaction. The aim of our study is to assess the feasibility, efficacy and safety of a hybrid hemorrhoidal artery ligation under digital guidance with laser hemorrhoidoplasty (Hybrid HAL-LHP) in patients with grade II to III hemorrhoids.Methods: In a prospective clinical study, hybrid HAL-LHP was performed in 75 consecutive patients between May 2018 to February 2020 with grade II to III hemorrhoids. Hemorrhoidal artery ligation was done by digital palpation followed by laser hemorrhoidoplasty using a 1470 nm diode laser. Postoperative pain and bleeding, return to work, resolution of symptoms, recurrence and reoperation was assessed on a follow up upto 1 year.Results: Postoperative pain assessed on Visual analog score (VAS) was 2.82 on 3rd day, 1.28 on 7th day and till 14th day was extremely low. None of the patients had significant intraoperative or spontaneous postoperative bleeding. Most of the patients had some degree of post defecation bleeding till 7th to 14 days which resolved after 2 weeks. After a mean follow up of 16.6 months, we reported a suspected recurrence rate of 5.33%.Conclusions: Postoperative pain assessed on Visual analog score (VAS) was 2.82 on 3rd day, 1.28 on 7th day and till 14th day was extremely low. None of the patients had significant intraoperative or spontaneous postoperative bleeding. Most of the patients had some degree of post defecation bleeding till 7 to 14 days which resolved after 2 weeks. After a mean follow up of 16.6 months we reported a suspected recurrence rate of 5.33%.

scholarly journals Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Piotr Walega ◽  
Michal Romaniszyn ◽  
Jakub Kenig ◽  
Roman Herman ◽  
Wojciech Nowak
Keyword(s):  
Safety Assessment ◽  
Mucosal Prolapse ◽  
Hemorrhoidal Disease ◽  
Functional Evaluation ◽  
Artery Ligation ◽  
Major Complications ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
Invasive Method ◽  
Grade Iii

Purpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL) called Recto-Anal-Repair (RAR) in treatment of advanced hemorrhoidal disease (HD).Methods: Patients with grade III and IV HD underwent the RAR procedure (DGHAL combined with restoration of prolapsed hemorrhoids to their anatomical position with longitudinal sutures). Each patient had rectal examination, anorectal manometry, and QoL questionnaire performed before 3 months, and 12 months after RAR procedure.Results: 20 patients completed 12-month followup. There were no major complications. 3 months after RAR, 5 cases of residual mucosal prolapse were detected (25%), while only 3 patients (15%) reported persistence of symptoms. 12 months after RAR, another 3 HD recurrences were detected, to a total of 8 patients (40%) with HD recurrence. Anal pressures after RAR were significantly lower than before (P<0.05), and the effect was persistent 12 months after RAR. One patient (5%) reported occasional soiling 3 months after RAR.Conclusions: RAR seems to be a safe method of treatment of advanced HD with no major complications. The procedure has a significant influence on anal pressures, with no evidence of risk of fecal incontinence after the operation.

scholarly journals Hemorrhoidal artery ligation with Doppler guidance vs digital guidance for grade II-III hemorrhoidal disease treatment

Medicine ◽  
2020 ◽  
Vol 99 (15) ◽  
pp. e19424
Author(s):  
Daniil Markaryan ◽  
Inna Tulina ◽  
Tatiana Garmanova ◽  
Mikhail Bredikhin ◽  
Aftandil Alikperzade ◽  
...  
Keyword(s):  
Hemorrhoidal Disease ◽  
Disease Treatment ◽  
Artery Ligation ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
Grade Ii

Doppler-Guided Hemorrhoidal Artery Ligation: Experience with 2 Years Follow-up

2012 ◽  
Vol 78 (3) ◽  
pp. 344-348 ◽  
Author(s):  
İbrahim Yilmaz ◽  
İlker Sücüllü ◽  
Dursun Özgür Karakaş ◽  
Yavuz Özdemİr ◽  
Ergün Yücel ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Artery Ligation ◽  
Superior Rectal Artery ◽  
Quick Recovery ◽  
Doppler Probe ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery

Doppler-guided hemorrhoidal artery ligation (DGHAL) is a nonexcisional surgical technique for the treatment of hemorrhoidal disease, consisting of the ligation of the distal branches of the superior rectal artery, resulting in a reduction of blood flow and decongestion of hemorrhoidal plexus resulting in fibrosis. The aim of the study was to assess the efficacy and safety of DGHAL, define its indications, and identify its possible advantages and limitations for the treatment of second- and third-degree hemorrhoids. The procedure was performed using a specially designed proctoscope. The Doppler probe was used to locate all the terminal branches of hemorrhoidal arteries, which were then sutured. Patients were followed up for 2 years. From November 2006 to May 2009, 50 patients (29 female, mean age 38.2 years) underwent this procedure. The procedure was performed under local anesthesia. An average of five ligatures was placed. Average length of hospital stay was 2 hours and return to work was 2.5 days. The mean postoperative pain score was 1.72. There were no intra- or immediate postoperative major complications. In 44 patients (88%), surgery resolved the symptoms completely in a 2-year follow-up period. DGHAL is a safe and effective procedure. DGHAL can be the choice for second- and third-degree hemorrhoids with minimal postoperative pain and quick recovery.

Long-term Results of Hemorrhoidal Artery Ligation

2016 ◽  
Vol 82 (3) ◽  
pp. 216-220
Author(s):  
İbrahim Yilmaz ◽  
Dursun ÖZgÜR Karakaş ◽  
İlker SÜCÜLlÜ
Keyword(s):  
Short Form ◽  
Long Term Results ◽  
Artery Ligation ◽  
Superior Rectal Artery ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
Grade Ii ◽  
Visual Analogous Scale

Aim of this study is to assess the efficacy, safety, and long-term results of doppler-guided hemorrhoidal artery ligation procedure with a 7-year follow-up period for treatment of grade II and III degree hemorrhoidal diseases. The procedure was performed by a specially designed proctoscope to locate and ligate all terminal branches of superior rectal artery. Patients were followed up at postoperative 1st week and 3rd, 12th, and 24th months by physical examination and 7th year by phone questionnaire using Short Form-36. Between November 2006 and May 2007, 50 patients (29 females, mean age = 38.2) underwent this procedure. All patients discharged at operation day and mean return to work was 2.5 days. There were no major complications and mean postoperative Visual Analogous Scale at first week was 1.72. At 24th month, 44 (88%) and 38 (76%) patients at 7th year were symptom free. Doppler-guided hemorrhoidal artery ligation is a safe, effective, and outpatient procedure, which can be the treatment of choice for second- and third-degree hemorrhoidal diseases with satisfactory long-term results.

Doppler-guided Hemorrhoidal Artery Ligation and Rectoanal Repair Modification for the Treatment of Grade III and Grade IV Hemorrhoids: One-year Follow-up

2014 ◽  
Vol 80 (12) ◽  
pp. 1279-1280
Author(s):  
Antonios Athanasiou ◽  
Dimitrios Karles ◽  
Adamantios Michalinos ◽  
Demetrios Moris ◽  
Eleftherios Spartalis ◽  
...  
Keyword(s):  
Artery Ligation ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
One Year ◽  
Rectoanal Repair ◽  
Grade Iii

scholarly journals Hemorrhoidal artery ligation without using a doppler guide: Is it a feasible and safe technique?

2021 ◽  
Vol 62 (3) ◽  
pp. 230-235
Author(s):  
Mahmut Said Degerli ◽  
Dogan Yildirim ◽  
Mikail Cakir ◽  
Okan Murat Akturk ◽  
Orcun Alpay ◽  
...  
Keyword(s):  
Operating Time ◽  
Operation Time ◽  
Hemorrhoidal Disease ◽  
Artery Ligation ◽  
Simple Method ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
The Mean ◽  
Grade 3 ◽  
One Year

The objective of this work was to analyze the results of the hemorrhoidal artery ligation technique without using a doppler guide, in patients with grade 3 hemorrhoidal disease; by evaluating cost-effectiveness, operation time, recurrence rate, postoperative pain, and secondary outcomes. A hemorrhoidal artery ligation procedure, without using a doppler guide, was performed on 43 patients (15 females, 28 males) with grade 3 symptomatic hemorrhoidal disease, from June 2015 to June 2019, in the Haseki Training and Research Hospital, Istanbul, Turkey. Patients were followed up clinically for one month. They completed a questionnaire within one year after their procedure. The median age was 46 years (range: 24 to 82 years). The main complaints were bleeding in 27 patients, pain in 22 patients, and skin tag in 14 patients. The mean preoperative VAS score was 3.4. The mean operating time was 18 mins (range: 13 to 25 min). All patients remained hospitalized for 24 h. Reoperation was necessary for only one patient because of bleeding. One year after the surgery, the pain was resolved in 21 (95.4%) out of 22 patients with preoperative pain, and bleeding resolved in 25 (92.5%) out of 27 patients with preoperative bleeding. The hemorrhoidal artery ligation is a simple method with a shorter learning curve producing similar postoperative results to other surgical procedures. The surgical technique is cost-effective as it does not require any particular device (anoscope with Doppler ultrasound) to apply.

scholarly journals Pathophysiology of hemorrhoidal disease and approach to its management

2014 ◽  
Vol 61 (2) ◽  
pp. 87-95
Author(s):  
Gupta Pravin ◽  
Gupta Shalini ◽  
Heda Purushottam
Keyword(s):  
Surgical Intervention ◽  
Lifestyle Modification ◽  
Degenerative Change ◽  
Disease Recurrence ◽  
Hemorrhoidal Disease ◽  
Evidence Based ◽  
Artery Ligation ◽  
Hemorrhoidal Artery Ligation ◽  
Downward Displacement ◽  
Hemorrhoidal Artery

Hemorrhoids are a very common anorectal disorder defined as the symptomatic enlargement and abnormally downward displacement of anal cushions. Hemorrhoids become pathognomonic due the degenerative change of supportive tissue within the anal cushions, vascular hyperplasia, and hyperperfusion of hemorrhoidal plexus. Early grades of hemorrhoids (Grade I and 2) can be effectively treated with dietary and lifestyle modification, pharmacological treatment, and different office-based procedures. Surgical intervention is indicated in symptomatic and advanced grades of hemorrhoids. Although hemorrhoidectomy is still considered as the gold standard, more recently, newer approaches like Ligasure and ultrasonic hemorrhoidectomy, stapled hemorrhoidopexy, and doppler-guided hemorrhoidal artery ligation have been used with a desirable success. However, post-procedural pain and disease recurrence remain the most challenging problems. This article deals with the pathophysiology and evidence based approach to hemorrhoidal diseases.

Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal Repair Outcome on Female Patients in Basra: Assessment Study

2021 ◽  
Vol 3 (1) ◽  
pp. 84-92
Author(s):  
Ohood Leabi ◽  
Alaa Abed ◽  
Wafa Al-Maliki
Keyword(s):  
Postoperative Complications ◽  
Anal Stenosis ◽  
Urine Retention ◽  
Artery Ligation ◽  
Assessment Study ◽  
Hemorrhoidal Artery Ligation ◽  
Hemorrhoidal Artery ◽  
New Treatment ◽  
Rectoanal Repair

Background: Hemorrhoidal disease is a common morbidity seen by general surgery clinics. Transanal Doppler guided (DG) hemorrhoidal artery ligation (HAL) with rectoanal repair (RAR) has been invented as a new treatment option. HAL-RAR was associated with mild to moderate postoperative complications in the literatures; and considered easy, safe, mostly painless procedure with very good results in treating hemorrhoids. Objective: This study was conducted to evaluate the outcome of using DG-HAL-RAR procedure through documenting postoperative complications during a median follow-up period of 18 months. Method: The study included 151 women presented with hemorrhoids in Basra, operated upon using the DG-HALRAR and complications assessed. Results: The patients’ mean age was 40–99 years. Most of the hemorrhoids were internal plus external (86.1%), of third degree (68.2%) and non-recurrent (90.1%). The surgical management needed an average of 6 ligations and 3 mucopexies. During the follow up periods, the most frequent complication was early bleeding, while the least was hemorrhoids recurrence. Discussion: During the follow up period, the postoperative complications were early bleeding, early pain, urine retention, late bleeding, anal stenosis, and hemorrhoids recurrence, the incidence of which were similar or close to the incidence of documented by other studies, except for early bleeding which was much higher than in our study. Some complications, reported by other studies,were not reported in this study. Conclusions: DG-HAL-RAR procedure can be used effectively and safely in second or third degree hemorrhoids. Keywords: Hemorrhoidectomy, Anal surgery, DG-HAL-RAR, Basra

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