Colour Doppler-guided Haemorrhoidal Artery Ligation: a possible evolution of Transanal Haemorrhoidal Dearterialisation.

Autor:	Palumbo VD; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Palumbo VD; Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy., Damiano G; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Sammartano A; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Messina M; Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Italy., Fazzotta S; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Curione F; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Cudia BM; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy., Lo Monte AI; Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
Jazyk:	angličtina
Zdroj:	La Clinica terapeutica [Clin Ter] 2021 Jul 05; Vol. 172 (4), pp. 329-335.
DOI:	10.7417/CT.2021.2337
Abstrakt:	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.
Databáze:	MEDLINE
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