Haemorrhoidal haemodynamic changes in patients with haemorrhoids treated using Doppler-guided dearterialization

Area of Science:

• Vascular Surgery
• Gastroenterology
• Medical Imaging

Background:

• Arterial hyperflow is a potential contributing factor in hemorrhoidal disease.
• Transanal hemorrhoidal dearterialization (THD) is a surgical technique used for hemorrhoid treatment.

Purpose of the Study:

• To evaluate the impact of THD on hemodynamic parameters within hemorrhoidal tissues.
• To assess changes in blood flow characteristics after THD surgery.

Main Methods:

• Endoanal ultrasonography and color Doppler imaging were used to assess internal hemorrhoids.
• Hemodynamic parameters including peak systolic velocity, pulsatility index, and resistivity index were measured before and 1 year after THD.
• Symptom severity was quantified using a standardized questionnaire.

Main Results:

• Postoperative measurements showed a significant decrease in peak systolic velocity, pulsatility index, and resistivity index.
• Acceleration time significantly increased, while end-diastolic velocity remained unchanged.
• All patients experienced significant symptom improvement or resolution within one year, with a marked reduction in symptom severity scores.

Conclusions:

• THD effectively modifies key hemodynamic parameters in internal hemorrhoids.
• The procedure is associated with a reduction in arterial hyperflow, correlating with clinical improvement.