title: Doppler-guided hemorrhoidal artery ligation: experience with 2 years follow-up.
abstract: Doppler-guided hemorrhoidal artery ligation (DGHAL) is a nonexcisional surgical technique for the treatment of hemorrhoidal disease, consisting of the ligation of the distal branches of the superior rectal artery, resulting in a reduction of blood flow and decongestion of hemorrhoidal  plexus resulting in fibrosis. The aim of the study was to assess the efficacy and safety of DGHAL, define its indications, and identify its possible advantages and limitations for the treatment of second- and third-degree hemorrhoids. The procedure was performed using a specially designed  proctoscope. The Doppler probe was used to locate all the terminal branches of hemorrhoidal arteries, which were then sutured. Patients were followed up for 2 years. From November 2006 to May 2009, 50 patients (29 female, mean age 38.2 years) underwent this procedure. The procedure was performed  under local anesthesia. An average of five ligatures was placed. Average length of hospital stay was 2 hours and return to work was 2.5 days. The mean postoperative pain score was 1.72. There were no intra- or immediate postoperative major complications. In 44 patients (88%), surgery resolved  the symptoms completely in a 2-year follow-up period. DGHAL is a safe and effective procedure. DGHAL can be the choice for second- and third-degree hemorrhoids with minimal postoperative pain and quick recovery.
authors.affiliation: Department of General Surgery, Gelibolu Military Hospital, Çanakkale, Turkey. dribrahimyilmaz@yahoo.com
authors.forename: İbrahim
authors.initials: İ
authors.lastname: Yilmaz
authors.forename: İlker
authors.initials: İ
authors.lastname: Sücüllü
authors.forename: Dursun Özgür
authors.initials: DÖ
authors.lastname: Karakaş
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Özdemir
authors.forename: Ergün
authors.initials: E
authors.lastname: Yücel
authors.forename: Mehmet Levhi
authors.initials: ML
authors.lastname: Akin
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008026:Ligation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D012005:Rectal Prolapse / Q000453:epidemiology; D025321:Surgery, Computer-Assisted; D014463:Ultrasonography; D014656:Vascular Surgical Procedures; D055815:Young Adult