Roka S, Gold D, Walega P, Lancee S, Zagriadsky E, Testa A, Kukreja A N, Salat A
Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Eur Surg. 2013 Feb;45(1):26-30. doi: 10.1007/s10353-012-0182-8. Epub 2013 Feb 9.
Ultrasound-guided techniques represent a new treatment option in the treatment of haemorrhoids. Doppler-guided haemorrhoidal artery ligation (DG-HAL) proved efficacious in early haemorrhoidal disease, but lacks efficacy for stages III/IV. For these patients, haemorrhoidal artery ligation (HAL) has been combined with a running suture to reduce prolapsing haemorrhoidal tissue (recto-anal repair (RAR)).
A prospective observational study was conducted in 184 patients with grade III (58 %) or grade IV (42 %) haemorrhoids in seven coloproctological centres. Primary endpoints were the recurrence of symptoms and need of further treatment (medical or surgical).
Post-operative complications were seen in 8 % of patients. After a follow-up of 3 months, 91 % of patients were free of symptoms and 91 % of patients were satisfied with the result. After a follow-up of 12 months, 89 % of patients were free of symptoms and 88 % were satisfied with the result. Nineteen per cent of patients received further medical or surgical treatment.
Doppler-guided recto-anal repair (DG-RAR) proves to be an effective treatment option for the treatment of advanced haemorrhoidal disease that shows equal results to other established treatment options.
超声引导技术是治疗痔疮的一种新的治疗选择。多普勒引导下痔动脉结扎术（DG-HAL）在早期痔病治疗中已被证明有效，但对III/IV期痔病缺乏疗效。对于这些患者，痔动脉结扎术（HAL）已与连续缝合相结合，以减少脱垂的痔组织（直肠肛管修复术（RAR））。
在7个结直肠病中心对184例III级（58%）或IV级（42%）痔疮患者进行了一项前瞻性观察研究。主要终点是症状复发和进一步治疗（药物或手术）的需求。
8%的患者出现术后并发症。随访3个月后，91%的患者无症状，91%的患者对结果满意。随访12个月后，89%的患者无症状，88%的患者对结果满意。19%的患者接受了进一步的药物或手术治疗。
多普勒引导下直肠肛管修复术（DG-RAR）被证明是治疗晚期痔病的一种有效治疗选择，其效果与其他既定治疗选择相当。
