Early Experience with Doppler-guided Hemorrhoidal Artery Ligation.

Lim, Minho; Kim, Kwang Ho; Chung, Soon Sup; Nam, Sun Young; Lee, Ryung Ah

doi:10.3393/jksc.2009.25.4.215

Original Article
Early Experience with Doppler-guided Hemorrhoidal Artery Ligation.: Lim, Minho , Kim, Kwang Ho , Chung, Soon Sup , Nam, Sun Young , Lee, Ryung Ah; Journal of the Korean Society of Coloproctology 2009;25(4):215-220
DOI: https://doi.org/10.3393/jksc.2009.25.4.215

Department of Surgery, Institute for Medical Science, Ewha Womans University School of Medicine, Seoul, Korea. ralee@ewha.ac.kr

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Abstract

PURPOSE
Doppler-guided hemorrhoidal artery ligation (HAL) is an alternative technique to the standard Milligan-Morgan hemorrhoidectomy. The purpose of this pilot study is to introduce the HAL technique for grade 2-3 internal hemorrhoids and to evaluate the efficacy of this technique in Korea in terms of results and patient satisfaction.
METHODS
The HAL procedure was performed on 29 patients with grade 2 or 3 internal hemorrhoids. Twenty-eight procedures were performed under local anesthesia with lidocaine, and one procedure was performed under general anesthesia due to synchronous surgery for gallstones. With the lithotomy position, the pulsation of the hemorrhoidal artery was localized using a doppler probe, and 3-6 branches of the hemorrhoidal artery were ligated with vicryl 2-0. Patient course was evaluated before and after the procedure by using questionnaires with a visual analog scale. RESULTS: The mean age of the patients was 44+/-24 yr. There were no significant complications with this procedure. At 3 mo after the operation, symptom scores of anal pain, anal bleeding, and anal prolapse were significantly improved (0.4, 1.0, and 2.4, respectively) compared to the symptom scores before the operation (3.4, 4.6, and 5.9, respectively). The postoperative satisfaction score was 8.1, and the recommendation score was 8.5. CONCLUSION: HAL is a safe and effective technique to relieve anal pain, bleeding, and prolapse of internal hemorrhoids. A comparative study with other procedures and a long-term follow-up after HAL should be the basis for valdating the efficacy of this procedure.

Keywords: Hemorrhoids;Doppler;Ligation

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Early Experience of Treatment for Symptomatic Hemorrhoids with Doppler Guided Hemorrhoidal Artery Ligation and Recto-anal Repair
Byoung-Hoon Jo, Jong Kyung Park, In Kyu Lee, Hyung-Jin Kim, Yoon-Suk Lee, Jae-Im Lee, Soo-Hong Kim, Won-Kyung Kang
Journal of the Korean Surgical Society.2010; 79(2): 116. CrossRef

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