Lienert M, Ulrich B
Chirurgische Abteilung der Kliniken und Seniorenzentren der Landeshauptstadt Düsseldorf gGmbH, Krankenhaus Gerresheim.
Dtsch Med Wochenschr. 2004 Apr 23;129(17):947-50. doi: 10.1055/s-2004-823061.
Since the beginning of 2001, Doppler-giuded ligation of the hemorrhoidal arteries (DG-HAL) has been used at this clinic in almost all patients with various forms of hemorrhoidal disease. Aim of this study was to ascertain whether this intervention can be done without general anaesthesia, the hemorrhoidal knots regress and this procedure provides advantages over the classical methods of treating hemorrhoids.
Early results of DG-HAL in 248 patients are presented. Through a special proctoscope the arteries leading to the hemorrhoidal cushions are located in the pain-free rectum under Doppler guidance and suture ligated. The form of anaesthesia, duration of the operation, numbers and sites of the ligatures, additional interventions and postoperative complications were recorded.
171 patients (69%) needed no anaethesia. 147 patients (Without additional interventions) were re-examined 6 weeks after the operation: 61.2% were free of symptoms. A total of 87.7% were at least improves. The complication rate was low.
In our experience DG-HAL has been a well tolerated efficacious method with few complications in the ambulatory treatment of hemorrhoids. The ideal indication for this methods is nonprolapsing hemorrhoids.
自2001年初起,本诊所几乎对所有患有各种类型痔疮疾病的患者都采用了多普勒引导下痔动脉结扎术(DG-HAL)。本研究的目的是确定该干预措施是否可以在不进行全身麻醉的情况下实施,痔核是否会消退,以及该手术方法是否比传统的痔疮治疗方法更具优势。
介绍了248例患者接受DG-HAL的早期结果。通过一种特殊的直肠镜,在多普勒引导下于无痛的直肠内定位通向痔垫的动脉,并进行缝合结扎。记录麻醉方式、手术持续时间、结扎的数量和部位、额外的干预措施以及术后并发症。
171例患者(69%)无需麻醉。147例患者(未进行额外干预)在术后6周接受复查:61.2%的患者无症状。总共87.7%的患者至少有所改善。并发症发生率较低。
根据我们的经验,DG-HAL在门诊治疗痔疮方面是一种耐受性良好、疗效显著且并发症较少的方法。该方法的理想适应症是非脱垂性痔疮。