Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease
Purpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL) called Recto-Anal-Repair (RAR) in treatment of advanced hemorrhoidal disease (HD). Methods: Patients with grade III and IV HD underwent the RAR proce...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
|
| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1100/2012/324040 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832552269781925888 |
|---|---|
| author | Piotr Walega Michal Romaniszyn Jakub Kenig Roman Herman Wojciech Nowak |
| author_facet | Piotr Walega Michal Romaniszyn Jakub Kenig Roman Herman Wojciech Nowak |
| author_sort | Piotr Walega |
| collection | DOAJ |
| description | Purpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL) called Recto-Anal-Repair (RAR) in treatment of advanced hemorrhoidal disease (HD). Methods: Patients with grade III and IV HD underwent the RAR procedure (DGHAL combined with restoration of prolapsed hemorrhoids to their anatomical position with longitudinal sutures). Each patient had rectal examination, anorectal manometry, and QoL questionnaire performed before 3 months, and 12 months after RAR procedure. Results: 20 patients completed 12-month followup. There were no major complications. 3 months after RAR, 5 cases of residual mucosal prolapse were detected (25%), while only 3 patients (15%) reported persistence of symptoms. 12 months after RAR, another 3 HD recurrences were detected, to a total of 8 patients (40%) with HD recurrence. Anal pressures after RAR were significantly lower than before (P<0.05), and the effect was persistent 12 months after RAR. One patient (5%) reported occasional soiling 3 months after RAR. Conclusions: RAR seems to be a safe method of treatment of advanced HD with no major complications. The procedure has a significant influence on anal pressures, with no evidence of risk of fecal incontinence after the operation. |
| format | Article |
| id | doaj-art-0365595a5a924c80bc095f6f4d336478 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-0365595a5a924c80bc095f6f4d3364782025-02-03T05:59:02ZengWileyThe Scientific World Journal1537-744X2012-01-01201210.1100/2012/324040324040Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal DiseasePiotr Walega0Michal Romaniszyn1Jakub Kenig2Roman Herman3Wojciech Nowak43rd Department of General Surgery, Jagiellonian University School of Medicine, Pradnicka Street 35-37, 31202 Krakow, Poland3rd Department of General Surgery, Jagiellonian University School of Medicine, Pradnicka Street 35-37, 31202 Krakow, Poland3rd Department of General Surgery, Jagiellonian University School of Medicine, Pradnicka Street 35-37, 31202 Krakow, PolandDepartment of Experimental and Clinical Surgery, Institute of Physiotherapy, Jagiellonian University School of Medicine, Michalowskiego Street 12, 31126 Krakow, Poland3rd Department of General Surgery, Jagiellonian University School of Medicine, Pradnicka Street 35-37, 31202 Krakow, PolandPurpose: We present 12-month followup results of functional evaluation and safety assessment of a modification of hemorrhoidal artery ligation (DGHAL) called Recto-Anal-Repair (RAR) in treatment of advanced hemorrhoidal disease (HD). Methods: Patients with grade III and IV HD underwent the RAR procedure (DGHAL combined with restoration of prolapsed hemorrhoids to their anatomical position with longitudinal sutures). Each patient had rectal examination, anorectal manometry, and QoL questionnaire performed before 3 months, and 12 months after RAR procedure. Results: 20 patients completed 12-month followup. There were no major complications. 3 months after RAR, 5 cases of residual mucosal prolapse were detected (25%), while only 3 patients (15%) reported persistence of symptoms. 12 months after RAR, another 3 HD recurrences were detected, to a total of 8 patients (40%) with HD recurrence. Anal pressures after RAR were significantly lower than before (P<0.05), and the effect was persistent 12 months after RAR. One patient (5%) reported occasional soiling 3 months after RAR. Conclusions: RAR seems to be a safe method of treatment of advanced HD with no major complications. The procedure has a significant influence on anal pressures, with no evidence of risk of fecal incontinence after the operation.http://dx.doi.org/10.1100/2012/324040 |
| spellingShingle | Piotr Walega Michal Romaniszyn Jakub Kenig Roman Herman Wojciech Nowak Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease The Scientific World Journal |
| title | Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease |
| title_full | Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease |
| title_fullStr | Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease |
| title_full_unstemmed | Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease |
| title_short | Doppler-Guided Hemorrhoid Artery Ligation with Recto-Anal-Repair Modification: Functional Evaluation and Safety Assessment of a New Minimally Invasive Method of Treatment of Advanced Hemorrhoidal Disease |
| title_sort | doppler guided hemorrhoid artery ligation with recto anal repair modification functional evaluation and safety assessment of a new minimally invasive method of treatment of advanced hemorrhoidal disease |
| url | http://dx.doi.org/10.1100/2012/324040 |
| work_keys_str_mv | AT piotrwalega dopplerguidedhemorrhoidarteryligationwithrectoanalrepairmodificationfunctionalevaluationandsafetyassessmentofanewminimallyinvasivemethodoftreatmentofadvancedhemorrhoidaldisease AT michalromaniszyn dopplerguidedhemorrhoidarteryligationwithrectoanalrepairmodificationfunctionalevaluationandsafetyassessmentofanewminimallyinvasivemethodoftreatmentofadvancedhemorrhoidaldisease AT jakubkenig dopplerguidedhemorrhoidarteryligationwithrectoanalrepairmodificationfunctionalevaluationandsafetyassessmentofanewminimallyinvasivemethodoftreatmentofadvancedhemorrhoidaldisease AT romanherman dopplerguidedhemorrhoidarteryligationwithrectoanalrepairmodificationfunctionalevaluationandsafetyassessmentofanewminimallyinvasivemethodoftreatmentofadvancedhemorrhoidaldisease AT wojciechnowak dopplerguidedhemorrhoidarteryligationwithrectoanalrepairmodificationfunctionalevaluationandsafetyassessmentofanewminimallyinvasivemethodoftreatmentofadvancedhemorrhoidaldisease |