Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up
Introduction Doppler-guided hemorrhoidal artery ligation (DGHAL), as a method of treating hemorrhoidal disease, is currently used in many centers across Europe, Asia, and Australia. The aim of our study was to evaluate the clinical effectiveness and functional results of DGHAL as estimated by means...
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| creator | Wałęga, Piotr Scheyer, Mathias Kenig, Jakub Herman, Roman M. Arnold, Steffen Nowak, Marcin Cegielny, Tomasz |
| description | Introduction
Doppler-guided hemorrhoidal artery ligation (DGHAL), as a method of treating hemorrhoidal disease, is currently used in many centers across Europe, Asia, and Australia. The aim of our study was to evaluate the clinical effectiveness and functional results of DGHAL as estimated by means of anorectal manometry.
Materials and methods
Between 2000 and 2006 the DGHAL procedure was performed on 507 patients with II–IV degree hemorrhoids in two centers (Poland and Austria). Three hundred eight patients were included in the initial phase of the study, designed to estimate the method’s effectiveness. During the second phase (199 patients) selected functional results were also assessed. Patients were classified as having grade II (144), III (319), and IV (44) hemorrhoids.
Results
There were no intra- and immediate postoperative complications. Good results were reported by 351 patients (69.2%), and were acceptable in a further 75 cases (4.8%). When the patients were grouped according to the stage of hemorrhoidal disease, 133 out of 144 patients (92.4%) with grade II and 272 out of 324 (84%) with grade III had very good or good results. Only 18 out of 44 patients (41%) with grade IV were satisfied with the operation. Fifty-nine patients after anorectal folds, fissure or anal canal polyp excision required analgesics for 1–2 days. Apart from lower contraction amplitude and contraction speed after 1 month there were no differences in anorectal functional tests.
Conclusion
Based on our results we may conclude that DGHAL is a safe and effective method and may offer an important alternative to operative hemorrhoidectomy with no risk of postoperative stool incontinence, minimal postoperative pain, and early return of patients to their normal activities. Nevertheless, this is a fairly new procedure with a short-term follow-up. Until 5-year observations of large, multicenter, randomized trials are published we cannot recommend this method as a gold-standard procedure, although it still can offer significant benefits to patients. |
| doi_str_mv | 10.1007/s00464-008-0030-x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_69664649</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1575658531</sourcerecordid><originalsourceid>FETCH-LOGICAL-c430t-91ee17fca50e17300b2f02e0f615fa466096a79c081f4603994e4ab4f6bfdec23</originalsourceid><addsrcrecordid>eNqFkc-KFDEQxoMo7rj6AF4kCHqLVtLpdMebrH9hwct6bjLpykyWdKdNutmZZ_FlTTODi4IYCFWkfvVVko-Q5xzecIDmbQaQSjKAtuwK2OEB2XBZCSYEbx-SDehyKBotL8iTnG-h4JrXj8kFb5UQda035OfNXWQWxxkTxcOEyeNokfqRznukc0IzD6VKo6N7HGJK--h7E2jvM5qMdMl-3NEPcZoCJrZbfI_9n6RJRftIg9-Z2cfxHXXLaNes1BLmJcyZGrfO5-yIJlEXQ4h3bJmekkfOhIzPzvGSfP_08ebqC7v-9vnr1ftrZmUFM9MckTfOmhpKrAC2woFAcIrXzkilQCvTaAstd1JBpbVEabbSqa3r0Yrqkrw-6U4p_lgwz93gs8UQzIhxyZ3SSpV_1v8FBYcys1nBl3-Bt3FJ5cUro2XNyyoQP0E2xZwTum5KfjDp2HHoVn-7k79d8bdb_e0OpefFWXjZDtjfd5wNLcCrM2CyNcElM1qff3MCWgVKysKJE5dLadxhur_hv6f_ArOpwHc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>219451111</pqid></control><display><type>article</type><title>Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Wałęga, Piotr ; Scheyer, Mathias ; Kenig, Jakub ; Herman, Roman M. ; Arnold, Steffen ; Nowak, Marcin ; Cegielny, Tomasz</creator><creatorcontrib>Wałęga, Piotr ; Scheyer, Mathias ; Kenig, Jakub ; Herman, Roman M. ; Arnold, Steffen ; Nowak, Marcin ; Cegielny, Tomasz</creatorcontrib><description>Introduction
Doppler-guided hemorrhoidal artery ligation (DGHAL), as a method of treating hemorrhoidal disease, is currently used in many centers across Europe, Asia, and Australia. The aim of our study was to evaluate the clinical effectiveness and functional results of DGHAL as estimated by means of anorectal manometry.
Materials and methods
Between 2000 and 2006 the DGHAL procedure was performed on 507 patients with II–IV degree hemorrhoids in two centers (Poland and Austria). Three hundred eight patients were included in the initial phase of the study, designed to estimate the method’s effectiveness. During the second phase (199 patients) selected functional results were also assessed. Patients were classified as having grade II (144), III (319), and IV (44) hemorrhoids.
Results
There were no intra- and immediate postoperative complications. Good results were reported by 351 patients (69.2%), and were acceptable in a further 75 cases (4.8%). When the patients were grouped according to the stage of hemorrhoidal disease, 133 out of 144 patients (92.4%) with grade II and 272 out of 324 (84%) with grade III had very good or good results. Only 18 out of 44 patients (41%) with grade IV were satisfied with the operation. Fifty-nine patients after anorectal folds, fissure or anal canal polyp excision required analgesics for 1–2 days. Apart from lower contraction amplitude and contraction speed after 1 month there were no differences in anorectal functional tests.
Conclusion
Based on our results we may conclude that DGHAL is a safe and effective method and may offer an important alternative to operative hemorrhoidectomy with no risk of postoperative stool incontinence, minimal postoperative pain, and early return of patients to their normal activities. Nevertheless, this is a fairly new procedure with a short-term follow-up. Until 5-year observations of large, multicenter, randomized trials are published we cannot recommend this method as a gold-standard procedure, although it still can offer significant benefits to patients.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-008-0030-x</identifier><identifier>PMID: 18622559</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Aged, 80 and over ; Anus ; Arteries - surgery ; Biological and medical sciences ; Cardiovascular system ; Chi-Square Distribution ; Female ; Follow-Up Studies ; Gastroenterology ; General aspects ; Gynecology ; Hemorrhoids ; Hemorrhoids - physiopathology ; Hemorrhoids - surgery ; Hepatology ; Humans ; Investigative techniques, diagnostic techniques (general aspects) ; Ligation - methods ; Male ; Manometry ; Medical sciences ; Medicine ; Medicine & Public Health ; Methods ; Middle Aged ; Patient satisfaction ; Performance evaluation ; Proctology ; Recovery of Function ; Rectum - blood supply ; Surgery ; Surgical outcomes ; Treatment Outcome ; Ultrasonic investigative techniques ; Ultrasonography, Doppler ; Ultrasonography, Interventional ; Veins & arteries</subject><ispartof>Surgical endoscopy, 2008-11, Vol.22 (11), p.2379-2383</ispartof><rights>Springer Science+Business Media, LLC 2008</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-91ee17fca50e17300b2f02e0f615fa466096a79c081f4603994e4ab4f6bfdec23</citedby><cites>FETCH-LOGICAL-c430t-91ee17fca50e17300b2f02e0f615fa466096a79c081f4603994e4ab4f6bfdec23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-008-0030-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-008-0030-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,778,782,27907,27908,41471,42540,51302</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20860644$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18622559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wałęga, Piotr</creatorcontrib><creatorcontrib>Scheyer, Mathias</creatorcontrib><creatorcontrib>Kenig, Jakub</creatorcontrib><creatorcontrib>Herman, Roman M.</creatorcontrib><creatorcontrib>Arnold, Steffen</creatorcontrib><creatorcontrib>Nowak, Marcin</creatorcontrib><creatorcontrib>Cegielny, Tomasz</creatorcontrib><title>Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
Doppler-guided hemorrhoidal artery ligation (DGHAL), as a method of treating hemorrhoidal disease, is currently used in many centers across Europe, Asia, and Australia. The aim of our study was to evaluate the clinical effectiveness and functional results of DGHAL as estimated by means of anorectal manometry.
Materials and methods
Between 2000 and 2006 the DGHAL procedure was performed on 507 patients with II–IV degree hemorrhoids in two centers (Poland and Austria). Three hundred eight patients were included in the initial phase of the study, designed to estimate the method’s effectiveness. During the second phase (199 patients) selected functional results were also assessed. Patients were classified as having grade II (144), III (319), and IV (44) hemorrhoids.
Results
There were no intra- and immediate postoperative complications. Good results were reported by 351 patients (69.2%), and were acceptable in a further 75 cases (4.8%). When the patients were grouped according to the stage of hemorrhoidal disease, 133 out of 144 patients (92.4%) with grade II and 272 out of 324 (84%) with grade III had very good or good results. Only 18 out of 44 patients (41%) with grade IV were satisfied with the operation. Fifty-nine patients after anorectal folds, fissure or anal canal polyp excision required analgesics for 1–2 days. Apart from lower contraction amplitude and contraction speed after 1 month there were no differences in anorectal functional tests.
Conclusion
Based on our results we may conclude that DGHAL is a safe and effective method and may offer an important alternative to operative hemorrhoidectomy with no risk of postoperative stool incontinence, minimal postoperative pain, and early return of patients to their normal activities. Nevertheless, this is a fairly new procedure with a short-term follow-up. Until 5-year observations of large, multicenter, randomized trials are published we cannot recommend this method as a gold-standard procedure, although it still can offer significant benefits to patients.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anus</subject><subject>Arteries - surgery</subject><subject>Biological and medical sciences</subject><subject>Cardiovascular system</subject><subject>Chi-Square Distribution</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hemorrhoids</subject><subject>Hemorrhoids - physiopathology</subject><subject>Hemorrhoids - surgery</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Ligation - methods</subject><subject>Male</subject><subject>Manometry</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Patient satisfaction</subject><subject>Performance evaluation</subject><subject>Proctology</subject><subject>Recovery of Function</subject><subject>Rectum - blood supply</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Treatment Outcome</subject><subject>Ultrasonic investigative techniques</subject><subject>Ultrasonography, Doppler</subject><subject>Ultrasonography, Interventional</subject><subject>Veins & arteries</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc-KFDEQxoMo7rj6AF4kCHqLVtLpdMebrH9hwct6bjLpykyWdKdNutmZZ_FlTTODi4IYCFWkfvVVko-Q5xzecIDmbQaQSjKAtuwK2OEB2XBZCSYEbx-SDehyKBotL8iTnG-h4JrXj8kFb5UQda035OfNXWQWxxkTxcOEyeNokfqRznukc0IzD6VKo6N7HGJK--h7E2jvM5qMdMl-3NEPcZoCJrZbfI_9n6RJRftIg9-Z2cfxHXXLaNes1BLmJcyZGrfO5-yIJlEXQ4h3bJmekkfOhIzPzvGSfP_08ebqC7v-9vnr1ftrZmUFM9MckTfOmhpKrAC2woFAcIrXzkilQCvTaAstd1JBpbVEabbSqa3r0Yrqkrw-6U4p_lgwz93gs8UQzIhxyZ3SSpV_1v8FBYcys1nBl3-Bt3FJ5cUro2XNyyoQP0E2xZwTum5KfjDp2HHoVn-7k79d8bdb_e0OpefFWXjZDtjfd5wNLcCrM2CyNcElM1qff3MCWgVKysKJE5dLadxhur_hv6f_ArOpwHc</recordid><startdate>20081101</startdate><enddate>20081101</enddate><creator>Wałęga, Piotr</creator><creator>Scheyer, Mathias</creator><creator>Kenig, Jakub</creator><creator>Herman, Roman M.</creator><creator>Arnold, Steffen</creator><creator>Nowak, Marcin</creator><creator>Cegielny, Tomasz</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7T7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20081101</creationdate><title>Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up</title><author>Wałęga, Piotr ; Scheyer, Mathias ; Kenig, Jakub ; Herman, Roman M. ; Arnold, Steffen ; Nowak, Marcin ; Cegielny, Tomasz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-91ee17fca50e17300b2f02e0f615fa466096a79c081f4603994e4ab4f6bfdec23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anus</topic><topic>Arteries - surgery</topic><topic>Biological and medical sciences</topic><topic>Cardiovascular system</topic><topic>Chi-Square Distribution</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hemorrhoids</topic><topic>Hemorrhoids - physiopathology</topic><topic>Hemorrhoids - surgery</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Ligation - methods</topic><topic>Male</topic><topic>Manometry</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Patient satisfaction</topic><topic>Performance evaluation</topic><topic>Proctology</topic><topic>Recovery of Function</topic><topic>Rectum - blood supply</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Treatment Outcome</topic><topic>Ultrasonic investigative techniques</topic><topic>Ultrasonography, Doppler</topic><topic>Ultrasonography, Interventional</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wałęga, Piotr</creatorcontrib><creatorcontrib>Scheyer, Mathias</creatorcontrib><creatorcontrib>Kenig, Jakub</creatorcontrib><creatorcontrib>Herman, Roman M.</creatorcontrib><creatorcontrib>Arnold, Steffen</creatorcontrib><creatorcontrib>Nowak, Marcin</creatorcontrib><creatorcontrib>Cegielny, Tomasz</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wałęga, Piotr</au><au>Scheyer, Mathias</au><au>Kenig, Jakub</au><au>Herman, Roman M.</au><au>Arnold, Steffen</au><au>Nowak, Marcin</au><au>Cegielny, Tomasz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2008-11-01</date><risdate>2008</risdate><volume>22</volume><issue>11</issue><spage>2379</spage><epage>2383</epage><pages>2379-2383</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Introduction
Doppler-guided hemorrhoidal artery ligation (DGHAL), as a method of treating hemorrhoidal disease, is currently used in many centers across Europe, Asia, and Australia. The aim of our study was to evaluate the clinical effectiveness and functional results of DGHAL as estimated by means of anorectal manometry.
Materials and methods
Between 2000 and 2006 the DGHAL procedure was performed on 507 patients with II–IV degree hemorrhoids in two centers (Poland and Austria). Three hundred eight patients were included in the initial phase of the study, designed to estimate the method’s effectiveness. During the second phase (199 patients) selected functional results were also assessed. Patients were classified as having grade II (144), III (319), and IV (44) hemorrhoids.
Results
There were no intra- and immediate postoperative complications. Good results were reported by 351 patients (69.2%), and were acceptable in a further 75 cases (4.8%). When the patients were grouped according to the stage of hemorrhoidal disease, 133 out of 144 patients (92.4%) with grade II and 272 out of 324 (84%) with grade III had very good or good results. Only 18 out of 44 patients (41%) with grade IV were satisfied with the operation. Fifty-nine patients after anorectal folds, fissure or anal canal polyp excision required analgesics for 1–2 days. Apart from lower contraction amplitude and contraction speed after 1 month there were no differences in anorectal functional tests.
Conclusion
Based on our results we may conclude that DGHAL is a safe and effective method and may offer an important alternative to operative hemorrhoidectomy with no risk of postoperative stool incontinence, minimal postoperative pain, and early return of patients to their normal activities. Nevertheless, this is a fairly new procedure with a short-term follow-up. Until 5-year observations of large, multicenter, randomized trials are published we cannot recommend this method as a gold-standard procedure, although it still can offer significant benefits to patients.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>18622559</pmid><doi>10.1007/s00464-008-0030-x</doi><tpages>5</tpages></addata></record> |
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| subjects | Abdominal Surgery Adult Aged Aged, 80 and over Anus Arteries - surgery Biological and medical sciences Cardiovascular system Chi-Square Distribution Female Follow-Up Studies Gastroenterology General aspects Gynecology Hemorrhoids Hemorrhoids - physiopathology Hemorrhoids - surgery Hepatology Humans Investigative techniques, diagnostic techniques (general aspects) Ligation - methods Male Manometry Medical sciences Medicine Medicine & Public Health Methods Middle Aged Patient satisfaction Performance evaluation Proctology Recovery of Function Rectum - blood supply Surgery Surgical outcomes Treatment Outcome Ultrasonic investigative techniques Ultrasonography, Doppler Ultrasonography, Interventional Veins & arteries |
| title | Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up |
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