Doppler-guided haemorrhoidal artery ligation with suture mucopexy compared with suture mucopexy alone for the treatment of grade III haemorrhoids: a prospective-randomised controlled trial

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Felix AignerHannes Gruber

Abstract

Novel minimally invasive techniques aimed to reposition the haemorrhoidal zone have been established for prolapsing haemorrhoids. We present a prospective randomised controlled trial to evaluate the efficacy of additional Doppler-guided ligation of submucosal haemorrhoidal arteries in patients with symptomatic grade III haemorrhoids. The trial was registered as ClinicalTrials. gov Identifier: NCT02372981. All consecutive patients with symptomatic grade III haemorrhoids were randomly allocated to one of the two study arms: (Group A) DG-HAL with mucopexy or (Group B) mucopexy alone. End points were postoperative pain, faecal incontinence, bleeding, residual prolapse and alterations of vascularisation of the anorectal vascular plexus. Vascularisation of the anorectal vascular plexus was assessed by transperineal contrast enhanced ultrasound. Patients recorded their symptoms in a diary maintained for a month. Forty patients were recruited and randomised to the two study groups. Patients in Group A had less pain in the first two postoperative weeks. At the 12-month follow-up, two patients in Group A (10%) and one in Group B (5%) showed recurrent grade III haemorrhoids (p=0.274). No significant morphological changes were observed in ...Continue Reading

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Citations

Feb 23, 2018·Techniques in Coloproctology·C Ratto
Dec 30, 2017·Techniques in Coloproctology·N J Smart, A Watson
Oct 11, 2017·Diseases of the Colon and Rectum·Valerio CelentanoJim Khan
Oct 28, 2017·Current Opinion in Gastroenterology·Danny O Jacobs
Mar 17, 2018·International Journal of Colorectal Disease·Robin R van TolStéphanie O Breukink
May 11, 2018·Gastroenterology Research and Practice·Gaetano GalloMario Trompetto
Feb 19, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·R R van TolS O Breukink
Jun 9, 2021·International Journal of Colorectal Disease·Bianca AibuedefeJuan Lucas Poggio

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