Die dopplergeführte Hämorrhoidalarterien-Ligatur

doi:10.1055/s-2004-823061

Cited by 24 publications

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References 3 publications

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“…Accurate and detailed symptoms assessment remains a milestone because some treatments proved to be more effective on specific symptoms, such as THD or HAL-RAR for bleeding 14 16 17 18 and CSH for HP. 19 20 21 Anyway, CSH resulted also to be effective in treating bleeding as major symptom.…”

Section: Discussionmentioning

confidence: 99%

Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)

Naldini¹,

Caminati²,

Sturiale³

et al. 2020

Surg J (N Y)

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Introduction The introduction and diffusion of new techniques for hemorrhoidal surgery have made it clear how much Goligher classification is inadequate in the modern times, lacking in any correlation between anatomical and clinical features to a surgical procedure. The aim of the study was to evaluate if the application of a new classification of hemorrhoidal diseases might lead to an improvement in the postoperative surgical outcomes. Methods From January 2014 to December 2015, all patients undergoing surgery for hemorrhoidal disease were enrolled. The procedures performed were based upon a new anatomical/clinical–therapeutic classification (A/CTC) considering these items: anatomical presentation, symptom types and frequency, associated diseases, and available surgical treatments and their related contraindications. The new classification identified four groups: A (outpatient), B, C, and D (surgical approaches). The overall outcomes were assessed and then stratified by surgical groups. These data were then analyzed in comparison with the published data about all the surgical procedures performed. Results A total of 381 patients underwent surgery and they were stratified as follows: Group B (39), C (202), and D (140). Group B underwent Doppler-guided dearterialization with mucopexies or tissue selective therapy, Group C stapled procedures, and Group D hemorrhoidectomy. The mean follow-up was 30 months. The overall outcomes were: success rate 92.4%, recurrences 7.6%, postoperative complications 4.8%, long-term complications 5.4%, and reoperation rate 2.7%. The success rates stratified by groups were: B, 85%); C, 91.4%; and D, 95.7%. Conclusion The A/CTC proved to be useful in stratifying the patients and choosing the proper treatment for each case. This classification seems to improve the outcome of different surgical procedures if compared with those already published.

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Section: Discussionmentioning

confidence: 99%

Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)

Naldini¹,

Caminati²,

Sturiale³

et al. 2020

Surg J (N Y)

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“…Postoperative infection was considered to be due to the special infection susceptibility of anus ( 20 ), however, it can be controlled by antibiotics. The secondary hemorrhage manifested as sticky bloody stool, which was considered to be related to mucosa damage, ischemic inflammatory necrosis, constipation and suture tear caused by hard stool ( 21 , 22 ). However, the hemorrhage was not severe, and it was suggested that patients at the Department of Anorectal Surgery following a light diet, with more fiber to avoid the secondary damage caused by constipation and hard stool.…”

Section: Discussionmentioning

confidence: 99%

Application of ‘tying, binding and fixing operation’ in surgical treatment of severe mixed hemorrhoids

Huang

Yao

Tang

2016

Experimental and Therapeutic Medicine

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The aim of the present study was to examine the clinical value of ‘tying, binding and fixing operation’ in treating severe mixed hemorrhoids. A total of 160 patients with severe mixed hemorrhoids were selected and randomly divided into the experimental (n=80) and control (n=80) groups. The groups were treated using ‘tying, binding and fixing operation’ and Doppler ultrasound-guided hemorrhoidal artery ligation (DG-HAL), respectively. The results showed that the average operative time of the experimental group (35.57±6.17) was significantly higher than that of the control group (12.73±4.92). There was no significant difference of blood loss during the operation between the two groups (P>0.05). There was also no significant difference in improving the hemorrhage symptom between the two groups (P>0.05). In addition, concerning improvement of prolapse symptoms and reduction of the volume of hemorrhoids, the experimental group were significantly improved as compared to the control group. No anal function damage in the two groups was identified, and the length of stay in hospital for the two groups was not significantly different (P>0.05). However, the hospitalization cost in the experimental group (5,334.77±875.54) was significantly lower than that of the control group (8,551.81±1,806.54) and satisfaction degree was significantly higher than that of the control group. The incidences of perianal pain, anal edema and dysuria between two groups were not significantly different (P>0.05). There were 10 cases of secondary hemorrhage and 18 cases of infection in the experimental group, and 12 cases of secondary hemorrhage and 14 cases of infection in the control group, although the differences between the two groups were not statistically significant (P>0.05). The incidence rate of local hematoma in the experimental group (1.2%) was significantly lower than that in the control group (15.0%). The recurrence rate of the control group (22.5%) was also significantly higher than that of the experimental group (2.5%). In conclusion, tying, binding and fixing operation is a promising method that may be employed for the treatment of sever mixed hemorrhoids, and it is better than DG-HAL in improving the prolapse and reducing the volume of hemorrhoids.

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“…While it is agreed that the convalescence period with DGHAL is very short, there is no unanimity that it could be performed without the aid of anesthesia [41], and that it does not require hospitalization [42]. The procedure is not found effective in controlling prolapse of hemorrhoids [38, 41, 43] and it does require an additional procedure like rubber band ligation for fixation of the hemorrhoids to eliminate their prolapse [44].…”

Section: Discussionmentioning

confidence: 99%

“…The procedure is not found effective in controlling prolapse of hemorrhoids [38, 41, 43] and it does require an additional procedure like rubber band ligation for fixation of the hemorrhoids to eliminate their prolapse [44]. The success rate reported with this technique varies between 62 and 90% on a short-term follow-up of less than 1 year [41, 44]. …”

Section: Discussionmentioning

confidence: 99%

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

Gupta¹

2005

Digestion

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Background: Many new techniques have been evolved to curb the problem of post-operative pain after hemorrhoidectomy. Stapler hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation are the two methods gaining popularity amongst proctologists. The author proposes another technique called radiofrequency ablation and fixation of hemorrhoids to add to this list. Patients and Methods: The surgical technique and clinical follow-up of 410 patients operated by this technique are presented. An Ellman radiofrequency generator was used for hemorrhoidal ablation at the output power intensity of 80. Post-defecation pain and pain at rest were assessed using a visual analogue scale. Patient satisfaction score was calculated at the mean follow-up of 60 months (range 48–72). The results in terms of mean hospital stay, post-operative pain, post-operative complications, and period of incapacity for work were compared with the published data of results of stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation. Results: Pain score at first evacuation was 6. The post-defecation pain score in the first week was 4 (range 3–6) and it was 3 (range 2–5) in the second week. The mean pain score at rest in the first week was 2 (range 1–4) and 1 (range 0–2) in the second post-operative week. In the long-term follow-up at a mean of 60 months, this procedure was found in most of the cases to control prolapse, discharge, and bleeding, with no stenosis or incontinence. The recurrence rate was less than 2%. The patient satisfaction score was high. Conclusion: The results of this technique of radiofrequency ablation and fixation of hemorrhoids hold positive promises in terms of less post-operative pain, early discharge from the hospital and faster return to work. The results are comparable to stapled hemorrhoidopexy and are better than Doppler-guided hemorrhoidal artery ligation in terms of effectiveness and symptomatic relief on a long-term basis.

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Die dopplergeführte Hämorrhoidalarterien-Ligatur

Abstract: 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.

Cited by 24 publications

References 3 publications

Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)

Improvement in Hemorrhoidal Disease Surgery Outcomes Using a New Anatomical/Clinical–Therapeutic Classification (A/CTC)

Application of ‘tying, binding and fixing operation’ in surgical treatment of severe mixed hemorrhoids

Hemorrhoidal Ablation and Fixation: An Alternative Procedure for Prolapsing Hemorrhoids

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