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Techniques in Coloproctology

Published in:

01-12-2011 | Original Article

Doppler-guided hemorrhoidal artery ligation does not offer any advantage over suture ligation of grade 3 symptomatic hemorrhoids

Authors: P. J. Gupta, S. Kalaskar, S. Taori, P. S. Heda

Published in: Techniques in Coloproctology | Issue 4/2011

Abstract

Background

Doppler-guided ligation of hemorrhoidal vessels is being proposed as a treatment of grade 2 and 3 hemorrhoids. Many researchers are coupling this procedure with mucopexy or lifting of hemorrhoids to control the prolapse more effectively. The present study was conducted in patients with 3rd-degree hemorrhoids to determine the usefulness of Doppler-guided hemorrhoidal artery ligation compared to mucopexy of prolapsing hemorrhoids and to compare it with mere mucopexy of the hemorrhoids.

Materials and methods

A double-blind, randomized controlled study was conducted on 48 consecutive patients with grade III hemorrhoids requiring surgery. The patients were randomized into two groups. Half of them were treated with ligation and mucopexy [SL], while the remaining patients underwent a Doppler-guided hemorrhoidal artery ligation followed by ligation and mucopexy [DSL]. The patients were examined by a blinded independent observer at 2, 4, and 6 weeks and at the end of 1 year after the operation to evaluate postoperative pain scores, amount of analgesics consumed, and complications encountered. The observer also assessed recurrence of hemorrhoids after 1 year.

Results

Operative time was significantly longer in the DSL group (31 min vs. 9 min P < 0.003). The postoperative pain score was significantly higher in the Doppler group [4.4 vs. 2.2, P < 0.002 (visual analogue scale)]. The mean total analgesic dose and duration of pain control using analgesics were greater and longer for the Doppler group than for the SL group (17 vs. 11 tablets, and 13 days vs. 9 days, respectively; P < 0. 01). Complications were similar in both the groups. At 1-year follow-up, the recurrence of hemorrhoids was not statistically significant in either group (4 patients in SL group and 3 patients in DSL group; P < 0.93).

Conclusions

Suture ligation of hemorrhoids is a simple, cost-effective, and convenient modality for treating grade 3 hemorrhoids. Doppler assistance in ligating the hemorrhoidal vessels prior to hemorrhoidal mucopexy offers no advantage and is a time-consuming procedure.

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Title: Doppler-guided hemorrhoidal artery ligation does not offer any advantage over suture ligation of grade 3 symptomatic hemorrhoids
Authors: P. J. Gupta
S. Kalaskar
S. Taori
P. S. Heda
Publication date: 01-12-2011
Publisher: Springer Milan
Published in: Techniques in Coloproctology / Issue 4/2011
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-011-0780-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Doppler-guided hemorrhoidal artery ligation does not offer any advantage over suture ligation of grade 3 symptomatic hemorrhoids

Abstract

Background

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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