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Published on: December 22, 2023
Results of 244 consecutive patients with hemorrhoids treated with Doppler-guided hemorrhoidal artery ligation
Robert A Pol1, Wil C van der Zwet, Daniel Hoornenborg
1Department of Surgery, Deventer Hospital, Deventer, The Netherlands. r.pol@dz.nl
Aim:
This study was designed to determine the effect of treating hemorrhoids with the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure.
Methods:
From June 2005 to March 2008, 244 consecutive hemorrhoidal patients underwent hemorroidal artery ligation performed with the DG-HAL system from AMI. All patients were evaluated postoperatively with a proctologic examination and interview. Further follow-up was performed by telephone with a standardized questionnaire. When indicated, patients revisited the clinic for further examination and treatment.
Results:
244 patients were treated with DG-HAL. The mean follow-up time was 18.4 months (range 1.4-37.2). Sixty-seven percent of the patients had an improvement of symptoms after one treatment. Fifty-three patients (22%) underwent a second procedure because of persisting symptoms. Thirteen patients (25%) underwent a second DG-HAL and 40 (75%) underwent rubber band ligation. In total, 69% of the patients had a good response using the DG-HAL technique. Multivariate logistic regression analysis revealed prolapse to be an independent risk factor for persistent symptoms (OR = 2.38, 95% CI 1.10-5.15). Patients with grades 3 and 4 hemorrhoids had a higher risk of developing recurrent disease (OR = 4.94, 95% CI 0.67-36.42).
Conclusion:
DG-HAL seems to be an effective procedure for treating low-grade hemorrhoids. A resection procedure should be the treatment for patients with recurrent disease.
