Open AccessHaemorrhoidal artery ligation with and without Doppler guidance in the treatment of haemorrhoidal disease: a single-centre randomized study
Author(s) -
Petr Tsarkov,
М. А. Поповцев,
Ю. С. Медкова,
Aftandil Alekberzade,
Н Н Крылов
Publication year - 2021
Publication title -
sečenovskij vestnik
Language(s) - English
Resource type - Journals
eISSN - 2658-3348
pISSN - 2218-7332
DOI - 10.47093/2218-7332.2021.274.01
Subject(s) - medicine , visual analogue scale , surgery , clinical endpoint , randomized controlled trial , stage (stratigraphy) , ligation , body mass index , patient satisfaction , paleontology , biology
Aim. To evaluate the efficacy of haemorrhoidal artery ligation (HA) with a preliminary palpatory determination of its localization supplemented by mucopexy of haemorrhoids as a new surgical method in the treatment of haemorrhoidal disease (HD) and to compare it with HAL-RAR technology. Materials and methods . The randomized controlled clinical trial included patients over 18 years old with Goligher's grade II, III or IV symptomatic HD. We operated on patients in the study group (n = 75) using palpatory determination of the localization of HA and subsequent mucopexia. In the control group (n = 75) we used HAL-RAR. The primary endpoint (25-30 days after surgery): recurrence rate of HD symptoms. Secondary endpoints: postoperative complication rate, pain intensity on a visual-analogue scale from 1 to 10 points, patient satisfaction with the treatment results on a 10-point scale. Results. According to the initial characteristics (age, gender, body mass index, stage of HD, frequency of clinical symptoms), the groups did not differ. Anal bleeding relapse developed: study group - 11%, control group -14%; relapse of haemorrhoids prolapse: 3% and 5% respectively (p > 0.05). Postoperative complications were noted in 6 (8%) in the study group and 4 (5%) in the control group (p > 0.05). The intensity of pain on the 2nd and 25-30 days after surgery was 6.3 [4.8; 7.4] and 1.2 [0.6; 2.5] points in the study group and 6.5 [4.9; 7.3] and 2.1 [1.9; 4.1] in the control group, respectively (p > 0.05). Patient satisfaction with the treatment results after 12 months was estimated at 8.7 [7.9; 9.2] and 9.4 [8.2; 9.6] in the study and control groups, respectively (p > 0.05). Conclusion. HA ligation with a preliminary palpatory determination of its localization and supplemented with mucopexy of haemorrhoids is no less effective than HAL-RAR in preventing haemorrhoidal bleeding and prolapse of the nodes.