Treatment of grade 2 and 3 hemorrhoids with Doppler-guided hemorrhoidal artery ligation

B M Wallis de Vries, E S J van der Beek, L R H de Wijkerslooth, W C van der Zwet, J A B van der Hoeven, M Eeftinck Schattenkerk, E H Eddes
Digestive Surgery 2007, 24 (6): 436-40

AIM: We evaluated the results of the Doppler-guided hemorrhoidal arterial ligation (DG-HAL) method in the management of symptomatic grade 2 and 3 hemorrhoids.

PATIENTS AND METHODS: Between June 2005 and March 2006, 110 consecutive patients with symptomatic grade 2 and 3 hemorrhoids according to the DG-HAL method were treated. All procedures were performed in daycare under spinal anesthesia. The primary objective was the reduction in hemorrhoidal gradation as determined by proctoscopy; the secondary was patient satisfaction. This was measured by interviewing patients over the telephone.

RESULTS: The average age was 47.6 years. 42 patients had grade 2 hemorrhoids, 68 grade 3. An average of 7.3 ligations were placed. Proctoscopy showed that, after 6 weeks, 97 (88%) patients had a significant improvement in their hemorrhoidal gradation. After an average follow-up of 37 weeks, 93 of the 110 (84.5%) patients were satisfied with the postoperative result. Mortality was 0% and morbidity 3%.

CONCLUSION: DG-HAL is a safe and effective treatment in the management of symptomatic grade 2 and 3 hemorrhoids.

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