Comparison of Doppler Guided Haemorrhoidal Artery Ligation (DG-HAL-RAR) with Open Haemorrhoidectomy.

ABSTRACT

Hemorrhoidal disease is a common reason for consultation in proctology and a public health problem responsible for discomfort and urgent request relief. Patients mostly complain of pain, discomfort, bleeding, and itching. Currently, combining an anoscope and a Doppler transducer makes it possible to detect and bind the arteries responsible for congestion selectively thereby reducing the blood flow and thus collapsing haemorrhoids.(1) Doppler-guided ligation of haemorrhoidal vessels is being proposed as a treatment of grade 2 and 3 haemorrhoids.(2)METHODSAll patients attending the outpatient department of general surgery at Sri Siddhartha Medical College and Research Institute with characteristics of grade 2 and grade 3 haemorrhoids were included in the study. In this prospective study, we compared the results of open haemorrhoidectomy and DGHAL techniques by means of duration of surgery, postoperative pain, post-operative need for analgesics, post hospital stay, and complications. Ninety-six patients were enrolled in this study and were subsequently divided into two groups of 48 members in each. Group A patients received an open haemorrhoidectomy and Group B received a DGHAL.RESULTSDuration of surgery was for DG-HAL group is significantly lesser than open haemorrhoidectomy. Post-operative pain score using VAS was significantly lesser in DG-HAL than open haemorrhoidectomy. Post-operative need for analgesics was significantly lesser in DG-HAL than open haemorrhoidectomy. Post-operative hospital stay, and complications were significantly lesser in DG-HAL group than Open haemorrhoidectomy.CONCLUSIONSDG HAL repair seems to be a safe method of treatment of 2nd and 3rd grade haemorrhoidal disease with no major complications and a high rate of good short-term results. DGHAL is more useful when compared to Milligan–Morgan technique in terms of duration of surgery, post-operative pain, post-operative need for analgesics, post-operative hospital stay, as DGHAL reduces the complications in surgery.