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: 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.

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 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 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

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

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

Long-term results with exophthalmos in a surgical series of 30 sphenoorbital meningiomas

2009 ◽  
Vol 111 (5) ◽  
pp. 1069-1077 ◽  
Author(s):  
Pietro Scarone ◽  
Delphine Leclerq ◽  
Françoise Héran ◽  
Gilles Robert
Keyword(s):  
Contrast Enhancement ◽  
Long Term Results ◽  
Subtotal Resection ◽  
Mr Images ◽  
Superior Orbital Fissure ◽  
Simpson Grade ◽  
Grade Ii ◽  
Sphenoorbital Meningioma

Object The authors analyzed the long-term results and radiological aspects of sphenoorbital meningioma (with emphasis on exophthalmos) in a series of 30 patients who underwent resection. Methods Data obtained in all 30 patients who underwent surgery for typical sphenoorbital meningioma at the authors' institution between June 1994 and September 2005 were analyzed retrospectively. The exophthalmos index (EI) was measured on preoperative MR images and/or CT scans and compared between the early and last follow-up examinations. All patients were women 35–74 years of age (median 51 years). Exophthalmos was the presenting symptom in 28 patients (93%), and was observed on preoperative MR images in all patients. The median duration of symptoms before surgery was 10 months (2–120 months). Results Total resection (Simpson Grade I) was not achieved in these patients because of the impossibility of resecting the dura mater in the superior orbital fissure without causing significant complications. Subtotal resection (Simpson Grade II) was obtained in 90% of patients, and in 3 patients (10%) a portion of the tumor was deliberately left in place because of extensive macroscopic infiltration of the cavernous sinus and/or extraocular muscles (Simpson Grade III). No patient died. Radiological evaluation at a median follow-up of 61 months (range 17–136 months) showed no contrast enhancement in 14 patients (47%), residual contrast enhancement without evolution in 13 (43%), and recurrence (new contrast enhancement) in 3 (10%). The EI was improved at the first radiological follow-up (median 12 months) in 27 patients (90%), and at the last radiological follow-up (median 61 months) in 28 patients (93%). In the interval between the first and final imaging follow-up, the EI improved in only 8 patients (20%), worsened in 15 patients (50%), and showed no variation in 7 patients (30%). Conclusions Sphenoorbital meningiomas are insidious tumors with slow progression. Even when exophthalmos is not clinically evident, it is always present on preoperative MR imaging. Total resection is not possible due to superior orbital fissure invasion, but subtotal resection (Simpson Grade II) can assure long-term stability due to the nonevolutive nature of most residual tumors. Exophthalmos improves at early radiological follow-up, but may worsen again as time passes.

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