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Doppler guided haemorrhoidal arterial ligation with recto‐anal‐repair (RAR) for the treatment of advanced haemorrhoidal disease
Author(s) -
Walega P.,
Krokowicz P.,
Romaniszyn M.,
Kenig J.,
Sałówka J.,
Nowakowski M.,
Herman R. M.,
Nowak W.
Publication year - 2010
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2009.02034.x
Subject(s) - medicine , surgery , ligation , anal canal , rectum
Objective A modification of Doppler guided haemorrhoidal artery ligation (DGHAL) to include the addition of recto‐anal repair is reported. Preliminary results of function and safety of third and fourth degree haemorrhoidals are given. Method Thirty patients underwent DGHAL combined with recto‐anal‐repair (RAR). Each had rectal examination, anorectal manometry and Quality of Life assessment before and 3 months after the procedure. Results Twenty‐nine patients were included in the final analysis. There were three (10.34%) patients of intra‐operative and one (3.45%) of postoperative bleeding. Three months after RAR (17.24%) patients with minor residual mucosal prolapse were detected, three (10.34%) patients reported residual symptoms. There was no case of recurrent bleeding. Anal manometry at 3 months after RAR was significantly lower than before the procedure ( P < 0.05). One (3.45%) patient reported occasional soiling 3 months after RAR. Conclusion Recto‐anal‐repair is safe in treating third and fourth degree haemorrhoids with no major complications and low rate of residual disease.