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The American Surgeon Mar 2016Aim 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...
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.
Topics: Adult; Aged; Arteries; Female; Follow-Up Studies; Hemorrhoidectomy; Hemorrhoids; Humans; Ligation; Male; Middle Aged; Patient Satisfaction; Surgery, Computer-Assisted; Time Factors; Treatment Outcome; Ultrasonography, Doppler; Young Adult
PubMed: 27099057
DOI: No ID Found -
Die Medizinische Welt Sep 1973
Topics: Disposable Equipment; Humans; Male; Proctoscopes; Rectal Neoplasms
PubMed: 4766309
DOI: No ID Found -
Nihon Rinsho. Japanese Journal of... Sep 2003
Review
Topics: Anal Canal; Humans; Microsurgery; Neoplasm Staging; Patient Selection; Proctoscopes; Proctoscopy; Rectal Neoplasms
PubMed: 14574925
DOI: No ID Found -
La Clinica Terapeutica Jul 2021Haemorrhoids are a very common disease, with a great economic burden. Many treatments have been developed for trying to solve the problem, being the standard not yet... (Comparative Study)
Comparative Study
INTRODUCTION
Haemorrhoids are a very common disease, with a great economic burden. Many treatments have been developed for trying to solve the problem, being the standard not yet found. In 1995, Doppler-guided haemorrhoidal artery ligation was introduced, aiming to reduce postoperative pain and complications. In this work, an evolu-tion of the aforementioned surgical technique was described.
MATERIALS AND METHODS
183 patients treated with standard Doppler-Guided Haemorrhoidal Artery Ligation were statistically compared with 225 patients dealt with Colour Doppler-Guided Haemorrhoidal Artery Ligation. The procedures were performed under local anaes-thesia with patients in lithotomy position. A special proctoscope and a dedicated Colourdoppler US probe were employed in the second group. Superior haemorrhoidal artery terminal branches were con-secutively ligated according to provided technique in the first group and under vision in the second. In all cases, each ligation was followed by mucopexy.
RESULTS
No significant differences between the two groups, in terms of post-operative pain, early complications (bleeding, urinary retention, incontinence) or patient satisfaction, were demonstrated. Recurrence rate was significantly higher in patients treated with stan-dard DG-HAL. No late complications (after one-year follow-up) were registered in both groups.
CONCLUSIONS
Colour Doppler-Guided Haemorrhoidal Artery Li-gation represents an ideal management for 1-day surgery, and fulfils the requirements of minimally invasive surgery in patients with III-IV grade haemorrhoids. The absence of complications and the evidence of significant wellness of patients are the best advantages. Colour Doppler-Guided Haemorrhoidal Artery Ligation is a safe and easy procedure with good results and a very short-time training. It could be considered an easy and reliable method to treat symptomatic haemorrhoids.
Topics: Adult; Echocardiography, Doppler, Color; Female; Hemorrhoidectomy; Hemorrhoids; Humans; Ligation; Male; Mesenteric Artery, Inferior; Middle Aged; Ultrasonography, Doppler
PubMed: 34247216
DOI: 10.7417/CT.2021.2337 -
Journal of the Anus, Rectum and Colon 2021There was an urgent need to create a simple, reliable hemorrhoidectomy procedure for high-risk cases in our university hospital. We performed linear pinched...
OBJECTIVES
There was an urgent need to create a simple, reliable hemorrhoidectomy procedure for high-risk cases in our university hospital. We performed linear pinched hemorrhoidectomy (LPH) and evaluated its effectiveness compared to conventional hemorrhoidectomy (CH).
METHODS
We included 215 Goligher grade 3 and 4 hemorrhoid cases in this study. Of these cases, 167 were in the CH group, and 48 patients were in the LPH group. We retrospectively compared the lengths of hospital stay, operative times, blood loss, and complications.
RESULTS
The age tended to be higher in the LPH group (mean: CH 60 years, LPH 68 years). In the univariate analysis, LPH had more resections, shorter operative times, and less blood loss. LPH had shorter operative times in the multivariate analysis, less blood loss, and more anticoagulant use. There were no significant differences between the two groups in terms of complications. Five and two patients in the CH and LPH groups, respectively, had postoperative hemorrhage requiring hemostasis. Only the CH group had three and four cases of anal stenosis and wound edema, respectively.
CONCLUSIONS
We studied simplified hemorrhoidectomy using an ultrasonic scalpel and cylindrical proctoscope in a university hospital. We found that it a useful procedure with few complications and was easy for residents to learn. We believe that advances in surgical devices will make it possible to perform safer and simpler hemorrhoidectomy in the future.
PubMed: 34395938
DOI: 10.23922/jarc.2020-076 -
Techniques in Coloproctology Mar 2014Transanal hemorrhoidal dearterialization (THD) is an effective treatment for hemorrhoidal disease. The ligation of hemorrhoidal arteries (called "dearterialization") can...
Transanal hemorrhoidal dearterialization (THD) is an effective treatment for hemorrhoidal disease. The ligation of hemorrhoidal arteries (called "dearterialization") can provide a significant reduction of the arterial overflow to the hemorrhoidal piles. Plication of the redundant rectal mucosa/submucosa (called "mucopexy") can provide a repositioning of prolapsing tissue to the anatomical site. In this paper, the surgical technique and perioperative patient management are illustrated. Following adequate clinical assessment, patients undergo THD under general or spinal anesthesia, in either the lithotomy or the prone position. In all patients, distal Doppler-guided dearterialization is performed, providing the selective ligation of hemorrhoidal arteries identified by Doppler. In patients with hemorrhoidal/muco-hemorrhoidal prolapse, the mucopexy is performed with a continuous suture including the redundant and prolapsing mucosa and submucosa. The description of the surgical procedure is complemented by an accompanying video (see supplementary material). In long-term follow-up, there is resolution of symptoms in the vast majority of patients. The most common complication is transient tenesmus, which sometimes can result in rectal discomfort or pain. Rectal bleeding occurs in a very limited number of patients. Neither fecal incontinence nor chronic pain should occur. Anorectal physiology parameters should be unaltered, and anal sphincters should not be injured by following this procedure. When accurately performed and for the correct indications, THD is a safe procedure and one of the most effective treatments for hemorrhoidal disease.
Topics: Anal Canal; Hemorrhoidectomy; Hemorrhoids; Humans; Ligation; Patient Positioning; Proctoscopes; Rectum; Ultrasonography, Doppler; Ultrasonography, Interventional
PubMed: 24026315
DOI: 10.1007/s10151-013-1062-3 -
Der Internist Jul 2003The endoscopic examination of the large intestine can be considered today a routine examination in internal medicine. Since the introduction of flexible videoendoscopy,... (Review)
Review
The endoscopic examination of the large intestine can be considered today a routine examination in internal medicine. Since the introduction of flexible videoendoscopy, evaluating diseases in the distal colon using rectoscopy has become less important. Anoproctoscopy is an obligatory component for a complete colon diagnostic after a flexible ileo-colonoscopy has been performed. Colonoscopy has improved significantly the diagnosis and therapy of diseases in the large intestine since it has been introduced more than 30 years ago. By introducing modern videocolonoscopy in addition to other instruments, there is today a broad spectrum of diagnostic and therapeutic indications available. Specifically, due to its frequency and prognostic relevance, colonoscopy has become the most powerful and important procedure in the early detection and prevention of colon cancer.
Topics: Colonic Diseases; Colonoscopes; Colonoscopy; Germany; Humans; Practice Patterns, Physicians'; Proctoscopes; Proctoscopy; Rectal Diseases
PubMed: 14631583
DOI: 10.1007/s00108-003-0932-6 -
Endoscopy Nov 1994In this article we describe the history, instrument, indications, and results of endoscopic ultrasonography (EUS) in the evaluation of perianorectal fistulas and...
In this article we describe the history, instrument, indications, and results of endoscopic ultrasonography (EUS) in the evaluation of perianorectal fistulas and abscesses. EUS has been reported to be helpful in the management of patients with Crohn's disease or colitis associated with fistulas and abscesses, due to its clear imaging of the leasion and valuable topographic anatomical information. Recent studies point out the relationship between EUS and electromyography. We believe EUS will become a standard procedure in the management of these complex disease processes.
Topics: Abscess; Colitis; Colonoscopes; Crohn Disease; Diagnosis, Differential; Endoscopes, Gastrointestinal; Humans; Proctoscopes; Rectal Diseases; Rectal Fistula; Ultrasonography, Interventional
PubMed: 7712999
DOI: 10.1055/s-2007-1009116 -
Gastrointestinal Endoscopy Sep 2007
Topics: Aged; Humans; Ligation; Lipoma; Male; Proctoscopes; Rectal Neoplasms; Surgical Instruments
PubMed: 17725963
DOI: 10.1016/j.gie.2007.03.1054 -
Khirurgiia 2016To compare two methods of hemorrhoid treatment. (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To compare two methods of hemorrhoid treatment.
MATERIAL AND METHODS
This prospective study included 240 patients with hemorrhoids stage III-IVA. Stages III and IVA were diagnosed in 156 (65%) and 84 (35%) patients respectively. Randomization was performed using envelopes method in one to one distribution. In group 1 (n=120) Doppler-assisted dearterialization of internal hemorrhoids with mucopexy was performed (DDM), in group 2 (n=120) - hemorrhoidectomy using harmonic scalpel (HE).
RESULTS
Duration of surgery was 17.9±6.1 and 34.5±10.1 minutes in DDM and HE groups respectively (p<0.01). Postoperative pain severity was higher in group 2 (4.8 compared with 2.5 scores of the first group (p<0.01). Narcotic analgesics were used less often in DDM group (1.3 doses compared with 6.1 doses in HE group (p<0.01). Disability period was 14.4±5.2 and 30.3±5.4 days in both groups respectively (p<0.01). Immediate postoperative complications occurred in 9 (7.5%) and 19 (15.8%) patients of DDM and HE groups respectively. Recurrent prolapse of internal hemorrhoids was diagnosed in 2 (1.7%) patients of the 1st group in terms of up to 45 days.
CONCLUSION
DDM is reliable minimally invasive method of hemorrhoids stage III-IVA treatment and has similar efficacy with HE. DDM reduces postoperative pain severity, hospital stay and disability period.
Topics: Adult; Comparative Effectiveness Research; Equipment Design; Female; Hemorrhoidectomy; Hemorrhoids; Humans; Intestinal Mucosa; Ligation; Male; Middle Aged; Minimally Invasive Surgical Procedures; Pain, Postoperative; Proctoscopes; Severity of Illness Index; Treatment Outcome; Ultrasonography, Interventional; Vascular Surgical Procedures
PubMed: 26977864
DOI: 10.17116/hirurgia2016224-28