Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome

Alemrajabi, Mahdi; Akbari, Abolfazl; Sohrabi, Sara; Rezazadehkermani, Mohammad; Moradi, Mohammad; Agah, Shahram; Masoodi, Mohsen

doi:10.3393/ac.2022.00017.0002

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…В последние несколько лет многочисленные работы также выявляют отсутствие существенной разницы ближайших и отдаленных результатов лечения при процедуре HAL-RAR, проводимой с применением ультразвукового контроля и без него [31][32][33].…”

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Analysis of Modern Minimally Invasive Techniques of Surgical Treatment of Hemorrhoidal Disease: A Literature Review

Черепенин,

Лутков,

Горский

2023

Хирургия. Восточная Европа

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В обзоре литературы представлено историческое развитие хирургических методов лечения геморроидальной болезни. Приводятся примеры наиболее эффективных современных малоинвазивных методик, анализируется опыт их применения, результаты различных комбинаций этих методик. Оценивается эффективность предлагаемых методов в зависимости от технической сложности применения, клинических ограничений, наличия осложнений, рецидивов заболевания и влияния на качество жизни пациентов. Также оценивается эволюция малоинвазивных методов лечения геморроя с течением времени на основании полученных ранее результатов лечения. Особое внимание уделено малоинвазивным методикам с прошиванием сосудистой ножки геморроидального узла, мукопексии и применению лазерных методик лечения геморроидальной болезни при 3-й и 4-й стадиях заболевания. Проанализированы печатные работы, посвященные физическим процессам, возникающим при лазерном воздействии на ткани в зависимости от длины волны применяемых лазерных установок. Также прослежена тенденция к комбинированию различных изолированных методик лечения геморроидальной болезни с целью повышения результата лечения пациентов с хроническим геморроем. The literature review presents the historical development of surgical methods for the treatment of hemorrhoids. Examples of the most effective modern minimally invasive techniques are given, the experience of their application, the results of various combinations of these techniques are analyzed. The effectiveness of the proposed methods is evaluated depending on the technical complexity of the application, clinical limitations, the presence of complications, relapses of the disease and the impact on the quality of life of patients. Special attention is paid to minimally invasive techniques with the residence of the vascular pedicle of the hemorrhoid node, mucopexy and the use of laser techniques for the treatment of hemorrhoidal disease at stages 3 and 4 of the disease. The printed works devoted to the physical processes that occur during laser exposure to tissues, depending on the wavelength of the laser installations used, are analyzed. There is also a tendency to combine various isolated methods of treatment of hemorrhoidal disease in order to improve the outcome of treatment of patients with chronic hemorrhoids.

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Section: резюме _____________________________________________________...unclassified

Analysis of Modern Minimally Invasive Techniques of Surgical Treatment of Hemorrhoidal Disease: A Literature Review

Черепенин,

Лутков,

Горский

2023

Хирургия. Восточная Европа

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“…In this technique, no excision is performed; instead, a pexy suture impedes the arterial inflow to the haemorrhoidal tissue [7]. Studies show that the addition of Doppler does not change the results achieved by the HAL [12,13]. As the HAL mainly focusses on the ligation of the arterial blood flow.…”

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confidence: 99%

Picking Up the Threads: Long-Term Outcomes of the Sutured Haemorrhoidopexy: A Retrospective Single-Centre Cohort Study

Kuiper

Dam

Kimman

et al. 2023

JCM

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Background: This study aimed to assess the short- and long-term safety and efficacy of the sutured haemorrhoidopexy (SH) in patients with haemorrhoidal disease (HD). Methods: A retrospective study was performed, assessing the following treatment characteristics: number of sutures needed; operation time; perioperative complications; postoperative pain; hospital stay. The short- and long-term postoperative complications, HD recurrence and data on current HD symptoms were assessed according to the Core Outcome Set for HD. Results: Between January 2009 and December 2021, 149 patients with HD underwent a SH. One-hundred and forty-five patients were included, with a mean age of 61 years (±12.8), of which 70 were women (48.3%). Patients were predominantly diagnosed with grade III (37.2%) HD and the median follow-up was nine years (5–11). Perioperative complications occurred in four cases (2.8%). In two patients (1.4%), short-term postoperative complications were reported, and in seven patients (6.2%), long-term complications were reported. The cumulative efficacy in terms of freedom of recurrence was 88.3% (95% CI, 83.1–93.5) at six months, 80.0% (95% CI, 73.5–86.5) at one year, and 67.7% (95% CI, 59.7–75.7) at five years. Conclusions: Sutured haemorrhoidopexy is a safe treatment for patients with HD and can be proposed as a minimally invasive surgical treatment if basic and outpatient procedures fail.

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Haemorrhoid artery ligation – recto anal repair (HAL‐RAR) blind versus Doppler: a systematic review and meta‐analysis

Liew,

Wang,

Chen

et al. 2024

ANZ Journal of Surgery

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BackgroundHaemorrhoids remain a highly prevalent condition in Australia, affecting 39% of the adult Australian population. While haemorrhoidectomy remains the gold standard in the management of haemorrhoids, newer techniques such as haemorrhoid artery ligation‐recto anal repair (HAL‐RAR) are emerging as promising management modalities. We compare the efficacy of non‐Doppler guided (non‐DG) HAL‐RAR versus Doppler‐guided (DG) HAL‐RAR in the management of haemorrhoids.MethodsThis study was registered with PROSPERO (CRD42022353806) and adhered to PRISMA 2020 guidelines. We conducted a systematic review using Medline, Embase and Cochrane database for comparative studies between Doppler‐guided HAL‐RAR and non‐Doppler‐guided HAL‐RAR in accordance with the PRISMA 2020 statement for reporting systematic reviews.ResultsFive studies were included in our systematic review and meta‐analysis. There was no clinically significant difference in operative times (SMD 0.46, 9% CI −3.16 0 4.08, P = 0.804) or post‐operative bleeding (P = 0.142) between the two groups. DG HAL‐RAR patients were more likely to have post‐operative urinary retention (P < 0.001). Non‐DG patients were less likely to experience recurrence (OR 5.12, P < 0.001).ConclusionOur review of non‐DG HAL‐RAR compared to DG HAL‐RAR reflects the non‐inferiority of the non‐DG HALRAR procedure. We hope that these results would provide a guide to clinicians performing HAL‐RAR, and would provide some cost savings for institutions who are unable to procure the necessary equipment for DG HAL‐RAR.

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Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome

Cited by 5 publications

References 26 publications

Analysis of Modern Minimally Invasive Techniques of Surgical Treatment of Hemorrhoidal Disease: A Literature Review

Analysis of Modern Minimally Invasive Techniques of Surgical Treatment of Hemorrhoidal Disease: A Literature Review

Picking Up the Threads: Long-Term Outcomes of the Sutured Haemorrhoidopexy: A Retrospective Single-Centre Cohort Study

Haemorrhoid artery ligation – recto anal repair (HAL‐RAR) blind versus Doppler: a systematic review and meta‐analysis

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