Resultados a un año tras desarterialización hemorroidal guiada por doppler

Gomez-Rosado, Juan-Carlos; Sanchez-Ramirez, María; Capitan-Morales, Luis C.; Valdés-Hernández, Javier; Reyes-Díaz, María Luisa; Cintas-Catena, Juan; Guerrero-Garcia, Juan M.; Gálan-Álvarez, Juan; Oliva-Mompeán, Fernando

doi:10.1016/j.ciresp.2012.03.002

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…Transanal hemorrhoidal dearterialization with Doppler was originally described by Morinaga et al In 1995, 15 but it was Ratto, who, in recent years, disseminated this technique. The technique is based on a reduction of the arterial flow to the hemorrhoidal tissue, associated or not with a procedure of mucopexy for repositioning of prolapsed tissue, 2,3,15,16 which is in line with the two most accepted pathophysiologies of hemorrhoidal disease: hyperflux and prolapse of the hemorrhoidal cushion. [17][18][19] For this purpose, an anoscope with a Doppler device at its tip (THD ® ) is used; this instrument pinpoints the largest arterial flow, usually in the six odd positions of the anus.…”

Section: Discussionmentioning

confidence: 99%

“…The description of the technique presupposes its completion under general anesthesia or spinal blockage. 2,3,15,16 Ratto states that the limited locoregional (local) anesthesia does not allow a complete intraoperative analgesia due to the visceral pain induced by the surgical ligation and suture for the mucopexy. 2 In our experience, sedation is the correct way to dodge visceral pain; for this method, this is an interesting association.…”

Section: Discussionmentioning

confidence: 99%

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The use of local anesthesia and sedation in transanal hemorrhoidal dearterialization with Doppler

Formiga

Magi

Santos

et al. 2018

Journal of Coloproctology

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The treatment of hemorrhoidal disease has never been as innovated as in recent decades. The transanal hemorrhoidal dearterialization with Doppler (THD) was described under general anesthesia or spinal blockage and there is no use of local anesthesia reports. This study aims to evaluate the safety of the use of local anesthesia with sedation in THD. For this purpose, two cases are reported describing the technical and safety analysis and results. Both patients were women with grade II and III hemorrhoidal disease. These patients underwent pre-anesthetic sedation with intravenous diazepam, then were positioned in lithotomy and sedated with midazolam and pethidine. The intersphincteric blockage was followed by THD with mucopexy. One patient made a small submucosal hematoma without expansion. The patients were stable and comfortable throughout the procedure. Both were discharged the next day, with regular analgesia. In the seventh postoperative day, both had mild annoyance at constant tenesmus, which was reduced gradually. The cases illustrate that THD is feasible when performed with local anesthesia and sedation, as it is safe and effective. This new technology can be incorporated into services that have a local anesthesia protocol as their standard.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The use of local anesthesia and sedation in transanal hemorrhoidal dearterialization with Doppler

Formiga

Magi

Santos

et al. 2018

Journal of Coloproctology

View full text Add to dashboard Cite

show abstract

“…However, this method is not able to induce the degeneration of chronic hemorrhoid tissues and obvious prolapsed hemorrhoids cannot completely shrink following the establishment of collateral circulation, which leads to an increase in pressure of hemorrhoids tissue. Consequently, it is not good at improving prolapse symptoms and decreasing hemorrhoid volume ( 4 – 6 , 9 – 12 ). It has been reported that DG-HAL and PPH have good therapeutic effect, however, the effect for hemorrhoids with prolapse symptoms is poor, which demonstrated the limit of therapeutical treatment including DG-HAL ( 13 , 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…The procedures of DG-HAL are comparatively safe, constituting this method as the most effective method for hemorrhoid ( 5 ). However, there are inevitable complications including postoperative secondary hemorrhage, infection, anal edge edema and pain, and the long-term effect remains to be clarified ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

Application of ‘tying, binding and fixing operation’ in surgical treatment of severe mixed hemorrhoids

Huang

Yao

Tang

2016

Experimental and Therapeutic Medicine

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The aim of the present study was to examine the clinical value of ‘tying, binding and fixing operation’ in treating severe mixed hemorrhoids. A total of 160 patients with severe mixed hemorrhoids were selected and randomly divided into the experimental (n=80) and control (n=80) groups. The groups were treated using ‘tying, binding and fixing operation’ and Doppler ultrasound-guided hemorrhoidal artery ligation (DG-HAL), respectively. The results showed that the average operative time of the experimental group (35.57±6.17) was significantly higher than that of the control group (12.73±4.92). There was no significant difference of blood loss during the operation between the two groups (P>0.05). There was also no significant difference in improving the hemorrhage symptom between the two groups (P>0.05). In addition, concerning improvement of prolapse symptoms and reduction of the volume of hemorrhoids, the experimental group were significantly improved as compared to the control group. No anal function damage in the two groups was identified, and the length of stay in hospital for the two groups was not significantly different (P>0.05). However, the hospitalization cost in the experimental group (5,334.77±875.54) was significantly lower than that of the control group (8,551.81±1,806.54) and satisfaction degree was significantly higher than that of the control group. The incidences of perianal pain, anal edema and dysuria between two groups were not significantly different (P>0.05). There were 10 cases of secondary hemorrhage and 18 cases of infection in the experimental group, and 12 cases of secondary hemorrhage and 14 cases of infection in the control group, although the differences between the two groups were not statistically significant (P>0.05). The incidence rate of local hematoma in the experimental group (1.2%) was significantly lower than that in the control group (15.0%). The recurrence rate of the control group (22.5%) was also significantly higher than that of the experimental group (2.5%). In conclusion, tying, binding and fixing operation is a promising method that may be employed for the treatment of sever mixed hemorrhoids, and it is better than DG-HAL in improving the prolapse and reducing the volume of hemorrhoids.

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“…It has been reported less post-operative pain compared with the stapler hemorhoidopexy, although it was not a zero pain surgical procedure. According to this limitation on performing standard Doppler-guided HAL-RAR procedure, direct ligation of the hemorrhoid pile without Doppler guided was another option to achieved the benefit and long-term clinical outcome of the standard one [4].…”

Section: Introductionmentioning

confidence: 99%

Three Years Recurrence Free of Hemorrhoid Artery Ligation-Rectoanal Repair with No Doppler Guided on Grade III of Internal Hemorrhoid Disease

Bagus

2023

Open Access Maced J Med Sci

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BACKGROUND: Surgical treatment of internal hemorrhoid is still challenging, short- and long-term clinical outcome were the most common issue. Chronic pain and recurrence case are the most common problem. Since it has been announced, HAL-RAR with Doppler guided is the treatment of choice, although it has economic issue on using this standard technique especially in the developing country which has limitation on health insurance. AIM: Using the same procedure as the standard HAL-RAR procedure and direct vision ligation, we hope that it could evaluate the clinical response of these modification technique on symptomatic Grade III of internal hemorrhoid cases. METHODS: We will evaluate the long-term clinical outcome of modified no Doppler guided technique on grade III of internal hemorrhoid cases. The inclusion criteria are the grade III of internal hemorrhoid, not associated with rectal cancer. A history of previous procedure or recurrence disease will be excluded from the study. Post-operative pain, 3 years recurrence disease, will be evaluated. RESULTS: We reported 65 patients, both of them have pain and bleeding. The procedure can be performed safely using direct vision and rectoscope. After 3 years, we reported there was no recurrence disease, no post-operative bleeding, and tolerable post-operative pain. We reported one case of chronic pain due to proctitis and could be managed conservatively. CONCLUSION: No Doppler-guided HAL-RAR was effective in controlling the post-operative pain, acceptable long-term clinical outcome with no recurrence.

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Resultados a un año tras desarterialización hemorroidal guiada por doppler

Cited by 7 publications

References 30 publications

The use of local anesthesia and sedation in transanal hemorrhoidal dearterialization with Doppler

The use of local anesthesia and sedation in transanal hemorrhoidal dearterialization with Doppler

Application of ‘tying, binding and fixing operation’ in surgical treatment of severe mixed hemorrhoids

Three Years Recurrence Free of Hemorrhoid Artery Ligation-Rectoanal Repair with No Doppler Guided on Grade III of Internal Hemorrhoid Disease

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