Treatment of grade 2 and 3 hemorrhoids with Doppler-guided hemorrhoidal artery ligation.
OBJECTIVE
We evaluated the results of the Doppler-guided hemorrhoidal arterial ligation (DG-HAL) method in the management of symptomatic grade 2 and 3 hemorrhoids.


METHODS
Between June 2005 and March 2006, 110 consecutive patients with symptomatic grade 2 and 3 hemorrhoids according to the DG-HAL method were treated. All procedures were performed in daycare under spinal anesthesia. The primary objective was the reduction in hemorrhoidal gradation as determined by proctoscopy; the secondary was patient satisfaction. This was measured by interviewing patients over the telephone.


RESULTS
The average age was 47.6 years. 42 patients had grade 2 hemorrhoids, 68 grade 3. An average of 7.3 ligations were placed. Proctoscopy showed that, after 6 weeks, 97 (88%) patients had a significant improvement in their hemorrhoidal gradation. After an average follow-up of 37 weeks, 93 of the 110 (84.5%) patients were satisfied with the postoperative result. Mortality was 0% and morbidity 3%.


CONCLUSIONS
DG-HAL is a safe and effective treatment in the management of symptomatic grade 2 and 3 hemorrhoids.
Wallis de Vries
B M
BM
Department of Surgery, Deventer Hospital, Deventer, The Netherlands. bmwallisdevries@home.nl
van der Beek
E S J
ES
de Wijkerslooth
L R H
LR
van der Zwet
W C
WC
van der Hoeven
J A B
JA
Eeftinck Schattenkerk
M
M
Eddes
E H
EH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D004867:Equipment Design; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D020700:Proctoscopes; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler