M Lienert1, B Ulrich. 1. Chirurgische Abteilung der Kliniken und Seniorenzentren der Landeshauptstadt Düsseldorf gGmbH, Krankenhaus Gerresheim.
Abstract
BACKGROUND AND OBJECTIVE: Since the beginning of 2001, Doppler-giuded ligation of the hemorrhoidal arteries (DG-HAL) has been used at this clinic in almost all patients with various forms of hemorrhoidal disease. Aim of this study was to ascertain whether this intervention can be done without general anaesthesia, the hemorrhoidal knots regress and this procedure provides advantages over the classical methods of treating hemorrhoids. PATIENTS AND METHODS: Early results of DG-HAL in 248 patients are presented. Through a special proctoscope the arteries leading to the hemorrhoidal cushions are located in the pain-free rectum under Doppler guidance and suture ligated. The form of anaesthesia, duration of the operation, numbers and sites of the ligatures, additional interventions and postoperative complications were recorded. RESULTS: 171 patients (69%) needed no anaethesia. 147 patients (Without additional interventions) were re-examined 6 weeks after the operation: 61.2% were free of symptoms. A total of 87.7% were at least improves. The complication rate was low. CONCLUSION: In our experience DG-HAL has been a well tolerated efficacious method with few complications in the ambulatory treatment of hemorrhoids. The ideal indication for this methods is nonprolapsing hemorrhoids.
BACKGROUND AND OBJECTIVE: Since the beginning of 2001, Doppler-giuded ligation of the hemorrhoidal arteries (DG-HAL) has been used at this clinic in almost all patients with various forms of hemorrhoidal disease. Aim of this study was to ascertain whether this intervention can be done without general anaesthesia, the hemorrhoidal knots regress and this procedure provides advantages over the classical methods of treating hemorrhoids. PATIENTS AND METHODS: Early results of DG-HAL in 248 patients are presented. Through a special proctoscope the arteries leading to the hemorrhoidal cushions are located in the pain-free rectum under Doppler guidance and suture ligated. The form of anaesthesia, duration of the operation, numbers and sites of the ligatures, additional interventions and postoperative complications were recorded. RESULTS: 171 patients (69%) needed no anaethesia. 147 patients (Without additional interventions) were re-examined 6 weeks after the operation: 61.2% were free of symptoms. A total of 87.7% were at least improves. The complication rate was low. CONCLUSION: In our experience DG-HAL has been a well tolerated efficacious method with few complications in the ambulatory treatment of hemorrhoids. The ideal indication for this methods is nonprolapsing hemorrhoids.
Authors: P P Dal Monte; C Tagariello; M Sarago; P Giordano; A Shafi; E Cudazzo; M Franzini Journal: Tech Coloproctol Date: 2007-12-03 Impact factor: 3.781