Doppler-Guided Hemorrhoidal Artery Ligation: An Alternative to Hemorrhoidectomy

Felice, G; Privitera, A; Ellul, Ernest; Klaumann, Maria

doi:10.1007/s10350-005-0166-x

Cited by 90 publications

(56 citation statements)

References 17 publications

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“…Regarding items in our study, their results supported our results in group B. (2,(13)(14)(15). In a study by Ramirez et al, they also evaluated symptom improvements in patients with grade IV hemorrhoids, who underwent the DGHAL technique and they concluded that most failures occurred in this group (up to 70%).…”

Section: Discussionsupporting

confidence: 80%

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Shabahang

Maddah

Fattahi

et al. 2013

Iran Red Crescent Med J

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Section: Discussionsupporting

confidence: 80%

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Shabahang

Maddah

Fattahi

et al. 2013

Iran Red Crescent Med J

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“…Different studies have shown that patients with recurrent disease and/or symptoms are suitable candidates for a second DG-HAL [2,5,9]. We initially performed 16 re-DG-HAL procedures.…”

Section: Discussionmentioning

confidence: 99%

“…By combining proctoscopy with a Doppler transducer, it is possible to selectively ligate the vessels in the hemorrhoidal plexus. Multiple studies have shown that Doppler-guided hemorrhoidal artery ligation (DG-HAL) is a safe and easy-to-learn technique with low recurrence rates, and possibly a good alternative to conventional treatments [5,6,7,8,9]. Nevertheless, the rates of effectiveness and patient satisfaction after long-term follow-up are still unknown and, currently, no large, prospective, randomized, controlled trial has been published.…”

Section: Introductionmentioning

confidence: 99%

Results of 244 Consecutive Patients with Hemorrhoids Treated with Doppler-Guided Hemorrhoidal Artery Ligation

Pol¹,

Zwet

Hoornenborg³

et al. 2010

Dig Surg

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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.

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“…Die nachfolgenden Arbeiten bestätigten die Therapieergebnisse. Jedoch wurden entweder sehr kleine Gruppen von 100 und weniger Patienten analysiert [4,6,8,21], oder die Nachbeobachtungszeit betrug einige Wochen bis maximal 1 Jahr [8,15,21,23]. Die Erfolgraten lagen zwischen 59% [21] und 100% [7], auch im Stadium III.…”

Section: Introductionunclassified

5 Jahre HAL: Erfahrungen und Langzeitergebnisse

Dorn¹,

Mory²

2007

Coloproctol

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Hintergrund und Ziel: Die Hämorrhoidenarterienligatur (HAL) ist seit einigen Jahren Bestandteil des therapeutischen Spektrums beim Hämorrhoidalleiden. Ihr Stellenwert wird immer noch kontrovers beurteilt. Ziel dieser Langzeitstudie war es, die eigenen Ergebnisse zu evaluieren und mit anderen Therapieoptionen zu vergleichen. Patienten und Methodik: Vom 01.09.2001 bis zum 31.01.2007 wurden 556 HAL bei Hämorrhoiden im Stadium I-III durchgeführt. Berichtet wird über die Ergebnisse von 200 Patienten, die 5 Jahre lang prospektiv nachkontrolliert wurden. Die Datenerhebung erfolgte nach einem ½ Jahr durch eine Nachuntersuchung sowie nach 2 und 5 Jahren durch Fragebögen und durch Nachuntersuchungen.Ergebnisse: Die Ergebnisse sind deutlich zeit-und stadienabhängig. Die primäre Erfolgsrate nach einem ½ Jahr lag bei 80,5% (Stadium I: 92,8%; Stadium II: 81,6%, Stadium III: 52,5%)‚ nach 2 Jahren bei 79% (Stadium I: 90%, Stadium II: 81,6%, Stadium III: 52,5%) und nach 5 Jahren bei 73,5% (Stadium I: 84,5%‚ Stadium II: 80,3%, Stadium III: 40%). 26,5% haben unveränderte Beschwerden bzw. mussten operativ behandelt werden (Stadium I: 15,5%, Stadium II: 19,7%, Stadium III: 60%).Schlussfolgerung: Die HAL ist im Stadium I besser als die Sklerosierung und im Stadium II effektiver als die Gummibandligatur, sowohl hinsichtlich der Erfolgs-als auch der Rezidivrate. Im Stadium III ist die HAL Therapie der zweiten Wahl. Ein ausgeprägter Trichteranus, ein langer Analkanal und eine sehr breite Hämorrhoidalzone sind relative Kontraindikationen.

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Doppler-Guided Hemorrhoidal Artery Ligation: An Alternative to Hemorrhoidectomy

Abstract: Doppler-guided ligation of the hemorrhoidal artery is a safe and effective alternative to hemorrhoidectomy and is associated with minimal discomfort and low risk of complications.

Cited by 90 publications

References 17 publications

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Comparison of Doppler Guided Hemorrhoid Artery Ligation and Milligan Morgan Hemorrhoidectomy in Management of Hemorrhoidal Disease

Results of 244 Consecutive Patients with Hemorrhoids Treated with Doppler-Guided Hemorrhoidal Artery Ligation

5 Jahre HAL: Erfahrungen und Langzeitergebnisse

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