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Clinical outcomes of Doppler-guided haemorrhoidal artery ligation: a meta-analysis
Hong Liu1, Chunmei Yang1, Benhui Chen1
1Department of Integrated Traditional and Western Medicine, Center of Hemorrhoid and Fistula, West China Hospital of Sichuan University Chengdu 610041, Sichuan, China.
Background And Objectives:
Numerous clinical studies have evaluated the potential benefits of DGHL for symptomatic hemorrhoids, particularly with regard to the perioperative parameters. However, the exact value of Doppler-assisted localization of vessels in hemorrhoid operations is still not clear. The aim of this study is to systematically analyze the randomized controlled trials on the effectiveness of DGHL and HL without Doppler guidance or other procedures for HD by using the principles of meta-analysis.
Materials And Methods:
Relevant RCTs which assessed DGHL as the primary procedure and reported clinical outcomes as primary end-points were selected from Pubmed database, Embase database and the Cochrane library. Mean difference (MD) was used to represent effect-quantity for continuous variable results, while Odds ratio (RR) was used to represent effect-quantity for discontinuous variable results. Statistical analysis was performed by RevMan 5.0 and STATA 12.0 software.
Results:
Five RCTs with a total of 388 patients were analyzed systematically. The main results showed that DGHL and HL without Doppler guidance or other procedures are equally effective in terms of treatment success rate (RR = 0.89, 95% CI 0.73-1.09, P = 0.27), operation time (MD = 11.41, 95% CI -9.26-32.09, P = 0.28), postoperative complications (RR = 0.89, 95% CI 0.62-1.28, P = 0.53), postoperative pain (MD = -1.01, 95% CI -2.27-0.26, P = 0.12) and incidence of HD recurrence (RR = 1.07, 95% CI 0.83-1.39, P = 0.60).
Conclusion:
Our findings suggest that DGHL may not have evident superiority for the management of HD in terms treatment success rate, operation time, postoperative complications, postoperative pain and incidence of HD recurrence. However, further large scale randomized and multicentre studies are needed to confirm these findings.
