ORIGINAL ARTICLE   

Minerva Surgery 2021 June;76(3):264-70

DOI: 10.23736/S2724-5691.20.08429-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Doppler-guided hemorrhoidal artery ligation with suture mucopexy compared with LigaSure™-assisted pile excision for the treatment of grade III hemorrhoids: a prospective randomized controlled trial

Xiao-Lun LEE ^{1, 2}, Kuo-Fang HSU ^{1, 2}, Yau-Dung JIN ³, Ping-Wun HUANG ⁴, Li-Chun YEH ^{1, 2, 5} ✉, Chung-Liang LAI ^{6, 7}

¹ Emergency Department, Hengchun Tourism Hospital, Taiwan, China; ² Department of Health and Welfare, Hengchun Tourism Hospital, Taiwan, China; ³ Chong Guang Clinic, Tainan, China; ⁴ Emergency Department, Changhua Show-Chwan Memorial Hospital, Changhua, China; ⁵ Emergency Department, Chang Bing Show-Chwan Memorial Hospital, Changhua, China; ⁶ Emergency Department, Puzi Hospital, Taiwan, China; ⁷ Department of Health and Welfare, Puzi Hospital, Taiwan, China

BACKGROUND: Doppler-guided hemorrhoid artery ligation and stapled hemorrhoidopexy have been used in surgical practices to avoid post-hemorrhoidectomy pain. Our study compared Doppler-guided hemorrhoid artery ligation with suture mucopexy (DGHAL-SM) and ligature-assisted pile excision (LAP) for greater than three grades of internal hemorrhoids.
METHODS: Eighty patients with greater than 3 grades of internal hemorrhoids were selected (age range: 20-28 years; average age: 23 years) between January and June 2015. The patients were randomly divided into group A (DGHAL-SM) and group B (LAP); each group had 40 patients.
RESULTS: With respect to the postoperative cure rate and anal skin tags, group A was inferior to group B, but the postoperative pain assessment and satisfaction were better than group B (P<0.001).
CONCLUSIONS: The DGHAL-SM cure rate was high; the postoperative pain was mild; 97.5% of the patients did not return to hospital because of pain. LAP has a higher cure rate than DGHAL-SM, but the postoperative pain and return rate within 6 h was as high as 65%, and the postoperative satisfaction assessment was lower than DGHAL-SM. Therefore, we recommend that DGHAL-SM for outpatient surgery in patients with greater than three grades of internal hemorrhoids.

KEY WORDS: Hemorrhoids; Sutures; Hemorrhoidectomy