Document Detail

Doppler-guided haemorrhoidal artery ligation: long-term outcome and patient satisfaction.
MedLine Citation:
PMID:  18573116     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Conventional Milligan-Morgan haemorrhoidectomy is associated with significant pain and potentially hazardous complications. Doppler-Guided Haemorrhoidal Artery Ligation (DGHAL) may offer a lower risk, pain-free alternative. We present our early and long-term outcome experience with DGHAL, combined with patient views and satisfaction with the procedure. METHOD: One hundred and thirteen DGHALs were performed over a 13 month period by two surgeons in a single centre. Patients graded the severity of postoperative pain on visual-analogue scales. Clinical follow-up was at 6 weeks (n = 103), with long-term follow-up (n = 90) by postal questionnaire at median of 30 months. RESULTS: Seven out of one hundred and three (6%) patients reported postoperative discomfort requiring analgesia. Ninety-three out of one hundred and three (90%) patients reported complete relief or significant improvement in their symptoms at 6 weeks, dropping to 77/90 (86%) at 30 months. Anal fissures developed in 2/103 (2%) patients, both treated with Diltiazem ointment. Further surgery was required in 8/90 (9%) patients. Eighty-two out of ninety (91%) patients said they would undergo DGHAL again. CONCLUSION: DGHAL is a relatively painless, safe, and effective procedure for symptomatic stage I-III haemorrhoids, for which we have demonstrated long-term durability and acceptability. Its role lies between office based procedures and more invasive operative interventions.
P M Wilkerson; M Strbac; H Reece-Smith; S B Middleton
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Publication Detail:
Type:  Journal Article     Date:  2008-06-28
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  11     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-06     Completed Date:  2009-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  394-400     Citation Subset:  IM    
Department of Colorectal Surgery, Royal Berkshire and Battle Hospitals, NHS Trust, Reading, UK.
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MeSH Terms
Aged, 80 and over
Follow-Up Studies
Hemorrhoids / rehabilitation,  surgery*,  ultrasonography*
Ligation / methods
Longitudinal Studies
Middle Aged
Pain, Postoperative / prevention & control
Patient Satisfaction
Recovery of Function
Ultrasonography, Interventional
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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