title: Outcomes of Doppler-guided hemorrhoid artery ligation: analysis of 90 consecutive patients.
abstract: BACKGROUND
  Doppler-guided hemorrhoid artery ligation is a minimal-invasive surgical treatment option for hemorrhoidal disease. The aim of our study was to evaluate the early and long-term results of the procedure 1 year after the operation.
  
  
  METHODS
  In a period of 4 years, 90 patients were included in this study. The Doppler-guided hemorrhoid artery ligation was performed under either spinal anesthesia or local perianal block. We recorded the length of postoperative inpatient care, on-demand analgesics administered apart from the standard analgesic protocol, short- and long-term complications, and, finally, recurrences.
  
  
  RESULTS
  The mean age of patients was 46 ± 12.6 years. The operation was performed under spinal anesthesia in 82 patients and under local perianal block in 8 patients. The mean operative time was 26 ± 4.1 min. On-demand analgesics administration was reported in sixteen patients (17.7%) the first postoperative day and in four patients (4.4%) the second postoperative day. A total of 58 patients (64.4%) were discharged from the hospital the day of the operation, 29 (32.2%) patients stayed overnight, and in three (3.3%) patients, a hospitalization period of 2 days was needed. Four patients (4.4%), two with grade III and two with grade IV hemorrhoids, developed early postoperative complications. Late complications were observed in three patients (3.3%). Recurrences, manifested either as bleeding or as prolapsing piles, were observed in six patients (6.6%), two patients with initial grade III and four with grade IV hemorrhoids.
  
  
  CONCLUSIONS
  Doppler-guided hemorrhoid artery ligation seems to be a safe and effective treatment option for all grades of hemorrhoidal disease. Further prospective randomized comparative studies are needed in order to fully evaluate the true role of DG-HAL in the surgical armamentarium.
authors: Department of General Surgery, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.
authors: M
authors: M
authors: Spyridakis
authors: G
authors: G
authors: Christodoulidis
authors: D
authors: D
authors: Symeonidis
authors: D
authors: D
authors: Dimas
authors: A
authors: A
authors: Diamantis
authors: E
authors: E
authors: Polychronopoulou
authors: K
authors: K
authors: Tepetes
mesh_terms: D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal; D001340:Autonomic Nerve Block; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005401:Fissure in Ano / Q000209:etiology; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006484:Hemorrhoids / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D012008:Recurrence; D013997:Time Factors; D018608:Ultrasonography, Doppler; D018084:Ultrasonography, Interventional; D055815:Young Adult