Hemorrhoids Research Today is a free monthly online journal that collates and summarizes the latest research about Hemorrhoids, including details on treatment, internal, external, surgery.

Doppler-Guided Haemorrhoidal Artery Ligation: Long-Term Outcome And Patient Satisfaction.

Wilkerson P, Strbac M, Reece-Smith H, Middleton S

Institute: Department of Colorectal Surgery, Royal Berkshire and Battle Hospitals NHS Trust, London Road, Reading, RG1 5AN, UK.

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. Patients and Methods 113 DGHALs were performed over a 13 month period by 2 surgeons in a single centre. Patients graded the severity of post-operative 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 7/103 (6%) patients reported post-operative discomfort requiring analgesia. 93/103 (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. 82/90 (91%) patients said they would undergo DGHAL again. Conclusions 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.

Published 24 June 2008 in Colorectal Dis.
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Articles on Hemorrhoids published 18 June 2008:

Risk Factors for Mortality in Lower Intestinal Bleeding.   Clin Gastroenterol Hepatol.

BACKGROUND & AIMS: Previous studies of lower intestinal bleeding (LIB) have limited power to study mortality. We sought to identify characteristics associated with in-hospital mortality in a large cohort of patients with LIB. METHODS: We used the 2002 Healthcare Cost and Utilization Project Nationwide Inpatient Sample to study a cross-sectional cohort of 227,022 hospitalized patients with discharge diagnoses indicating LIB. Predictors of mortality were identified by using multiple logistic ... [Abstract] [Full-text]

Articles on Hemorrhoids published 16 June 2008:

Circular Stapled Hemorrhoidopexy: Experience of a Single Center with 445 Cases.   World J Surg.

This study was designed to review the results of circular stapled hemorrhoidopexy (CSH) in the management of second-, third-, and fourth-degree hemorrhoidal disease. The medical records of 483 patients who had undergone circular stapled hemorrhoidopexy for symptomatic hemorrhoidal disease from June 2001 to September 2006 were evaluated. Data regarding complications, residual symptoms, and recurrence were collected. The study included 445 patients (283 men, 162women) between 22 and 74 years old ... [Abstract] [Full-text]

Articles on Hemorrhoids published 11 June 2008:

Randomized clinical trial comparing LigaSure haemorrhoidectomy with open diathermy haemorrhoidectomy.   Tech Coloproctol.

BACKGROUND: Milligan-Morgan excision haem-orrhoidectomy remains a very popular treatment modality for third and fourth degree haemorrhoids due to its cost effectiveness and good long-term results. The LigaSure tissue-sealing device is an alternative technique used in haemorrhoidectomy that has been shown to produce favourable results. The aim of this study was to assess the effectiveness of the LigaSure tissue sealing device in comparison with conventional diathermy haemorrhoidectomy. METHODS: ... [Abstract] [Full-text]

Ligation under vision of haemorrhoidal cushions for therapy of bleeding haemorrhoids.   Tech Coloproctol.

Ligation under vision (LUV) is a simple method for the surgical treatment of haemorrhoids. In this study, we evaluated the results of our initial experience with the procedure in terms of postoperative pain, patients' final satisfaction and complications. We reviewed a group of patients who had undergone suture ligation of symptomatic haemorrhoids of grade II and III. This was performed with the haemorrhoids under direct vision and without the use of any ancillary instrumentation such as a ... [Abstract] [Full-text]

Articles on Hemorrhoids published 3 June 2008:

Doppler-guided hemorrhoidal artery ligation for the treatment of symptomatic hemorrhoids: early and three-year follow-up results in 100 consecutive patients.   Dis Colon Rectum, 51(6): 945-9.

PURPOSE: Doppler-guided ligation of the hemorrhoidal arteries was described as an alternative to hemorrhoidectomy. The authors report their experience with this procedure. METHODS: From 2002 to 2004, 100 consecutive patients underwent hemorrhoidal artery ligation procedure for symptomatic hemorrhoids and were reviewed at one month and at three years. RESULTS: There were 54 females. Seventy-eight patients had Grade III hemorrhoids. Eighteen patients had previously been treated for the disease. ... [Abstract] [Full-text]

Stapled anopexy: postoperative course and functional outcome in 400 patients.   Dis Colon Rectum, 51(6): 950-5.

PURPOSE: We performed a retrospective analysis of postoperative course and functional outcome after at least six months' follow-up in a series of 400 consecutive patients who underwent stapled anopexy. METHODS: All patients were evaluated at one week and one month after surgery and then according to symptoms. A clinical or telephone follow-up was obtained for all patients. The last 50 patients were prospectively evaluated with an obstructive defecation syndrome score and Wexner continence and ... [Abstract] [Full-text]

Articles on Hemorrhoids published 30 May 2008:

Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures.   Tech Coloproctol, 12(1): 7-19.

Procedure for prolapsing hemorrhoids (PPH) and stapled transanal rectal resection for obstructed defecation (STARR) carry low postoperative pain, but may be followed by unusual and severe postoperative complications. This review deals with the pathogenesis, prevention and treatment of adverse events that may occasionally be life threatening. PPH and STARR carry the expected morbidity following anorectal surgery, such as bleeding, strictures and fecal incontinence. Complications that are ... [Abstract] [Full-text]

Articles on Hemorrhoids published 28 May 2008:

Hemorrhoids can be a Source of Obscure Gastrointestinal Bleeding that Requires Transfusion: Report of Five Patients.   Dis Colon Rectum.

PURPOSE: Hemorrhoids have been rarely reported to be a source of transfusion-dependent, obscure gastrointestinal bleeding. We report the diagnosis and management of a series of patients in whom hemorrhoids were the source of obscure gastrointestinal bleeding that was severe enough to require transfusion. METHODS: Five patients, who presented with severe hematochezia or obscure gastrointestinal bleeding, during a 24-month period had had an extensive workup for gastrointestinal bleeding. All had ... [Abstract] [Full-text]

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