Department of General Surgery, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece.
Tech Coloproctol. 2011 Oct;15 Suppl 1:S21-4. doi: 10.1007/s10151-011-0727-z.
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.
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.
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.
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.
多普勒引导痔动脉结扎术是治疗痔病的一种微创外科治疗选择。我们的研究目的是评估手术后 1 年的早期和长期结果。
在 4 年期间，本研究纳入了 90 例患者。多普勒引导痔动脉结扎术在椎管内麻醉或局部肛周阻滞下进行。我们记录了术后住院时间、标准镇痛方案外按需给予的镇痛剂、短期和长期并发症以及最终的复发情况。
患者的平均年龄为 46 ± 12.6 岁。82 例患者在椎管内麻醉下进行手术，8 例患者在局部肛周阻滞下进行手术。手术平均时间为 26 ± 4.1 分钟。16 例患者（17.7%）在术后第 1 天和 4 例患者（4.4%）在术后第 2 天需要按需给予镇痛剂。共有 58 例患者（64.4%）在手术当天出院，29 例患者（32.2%）住院过夜，3 例患者（3.3%）需要住院 2 天。4 例患者（4.4%），其中 2 例为 III 级痔，2 例为 IV 级痔，发生了早期术后并发症。3 例患者（3.3%）观察到晚期并发症。6 例患者（6.6%）出现复发，表现为出血或脱垂的痔，其中 2 例为初始 III 级痔，4 例为 IV 级痔。
多普勒引导痔动脉结扎术似乎是治疗所有等级痔病的安全有效治疗选择。需要进一步的前瞻性随机对照研究，以充分评估 DG-HAL 在手术武器库中的真正作用。
