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首页> 外文期刊>Surgical Endoscopy >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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Two-center experience in the treatment of hemorrhoidal disease using Doppler-guided hemorrhoidal artery ligation: functional results after 1-year follow-up.

机译：多普勒引导下痔动脉结扎术治疗痔疮疾病的两个中心经验：1年随访后的功能结果。

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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.
机译：引言：多普勒引导的痔疮动脉结扎术（DGHAL）作为治疗痔疮疾病的方法，目前在欧洲，亚洲和澳大利亚的许多中心均得到使用。我们研究的目的是评估通过肛门直肠测压法评估的DGHAL的临床有效性和功能结果。材料与方法：在2000年至2006年之间，在两个中心（波兰和奥地利）对507名II-IV级痔疮患者进行了DGHAL手术。该研究的初始阶段包括308名患者，旨在评估该方法的有效性。在第二阶段（199例患者）中，还评估了选定的功能结果。患者被分类为II级（144），III级（319）和IV级（44）痔疮。结果：没有术中和术后并发症。 351例患者报告了良好的结果（69.2％），另外75例患者接受了良好的结果（4.8％）。根据痔疮疾病分期对患者进行分组时，144例II级患者中有133名（92.4％）和324级III级患者中272名（324％）中的272例非常好。 IV级44例患者中只有18例（41％）对手术满意。五十九例患者在肛门直肠褶皱，裂痕或肛管息肉切除后需要镇痛药1-2天。除了在1个月后降低收缩幅度和收缩速度外，肛肠功能测试无差异。结论：基于我们的研究结果，我们可以得出结论，DGHAL是一种安全有效的方法，并且可以为痔疮手术切除提供重要的替代方法，并且没有术后大便失禁的风险，术后疼痛最小，患者可以早日恢复正常活动。尽管如此，这是一个相当新的程序，需要短期随访。在发表对大型，多中心，随机试验的5年观察结果之前，尽管该方法仍可以为患者带来巨大的收益，但我们仍不建议将该方法作为金标准程序。

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