Outcomes of Doppler-guided hemorrhoid artery ligation: analysis of 90 consecutive patients.

Abstract

BACKGROUND:

Doppler-guided hemorrhoid artery ligation is a minimal-invasive surgical treatment option for hemorrhoidal disease. The aim of our study was to evaluate the early and long-term results of the procedure 1 year after the operation.

PATIENTS AND METHODS:

In a period of 4 years, 90 patients were included in this study. The Doppler-guided hemorrhoid artery ligation was performed under either spinal anesthesia or local perianal block. We recorded the length of postoperative inpatient care, on-demand analgesics administered apart from the standard analgesic protocol, short- and long-term complications, and, finally, recurrences.

RESULTS:

The mean age of patients was 46 ± 12.6 years. The operation was performed under spinal anesthesia in 82 patients and under local perianal block in 8 patients. The mean operative time was 26 ± 4.1 min. On-demand analgesics administration was reported in sixteen patients (17.7%) the first postoperative day and in four patients (4.4%) the second postoperative day. A total of 58 patients (64.4%) were discharged from the hospital the day of the operation, 29 (32.2%) patients stayed overnight, and in three (3.3%) patients, a hospitalization period of 2 days was needed. Four patients (4.4%), two with grade III and two with grade IV hemorrhoids, developed early postoperative complications. Late complications were observed in three patients (3.3%). Recurrences, manifested either as bleeding or as prolapsing piles, were observed in six patients (6.6%), two patients with initial grade III and four with grade IV hemorrhoids.

CONCLUSION:

Doppler-guided hemorrhoid artery ligation seems to be a safe and effective treatment option for all grades of hemorrhoidal disease. Further prospective randomized comparative studies are needed in order to fully evaluate the true role of DG-HAL in the surgical armamentarium.

• Authors: M Spyridakis, G Christodoulidis, D Symeonidis, D Dimas, A Diamantis, E Polychronopoulou, K Tepetes
• Journal: Techniques in coloproctology (Tech Coloproctol) Vol. 15 Suppl 1 Pg. S21-4 (Oct 2011) ISSN: 1128-045X [Electronic] Italy
• PMID: 21887577 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Anesthesia, Spinal
• Autonomic Nerve Block
• Fecal Incontinence (etiology)
• Female
• Fissure in Ano (etiology)
• Follow-Up Studies
• Hematoma (etiology)
• Hemorrhoids (diagnostic imaging, surgery)
• Humans
• Ligation (adverse effects)
• Male
• Middle Aged
• Pain, Postoperative (drug therapy, etiology)
• Recurrence
• Time Factors
• Ultrasonography, Doppler
• Ultrasonography, Interventional
• Young Adult