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. 2023 Aug;39(4):351-356.
doi: 10.3393/ac.2022.00017.0002. Epub 2022 May 16.

Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome

Mahdi Alemrajabi  1 , Abolfazl Akbari  1 , Sara Sohrabi  1 , Mohammad Rezazadehkermani  1 , Mohammad Moradi  1   2 , Shahram Agah  1 , Mohsen Masoodi  1
Affiliations

Simple mucopexy and hemorrhoidal arterial ligation with and without Doppler guide: a randomized clinical trial for short-term outcome

Mahdi Alemrajabi et al. Ann Coloproctol. 2023 Aug.

Abstract

Purpose: Hemorrhoids are the most common benign anorectal diseases. Mucopexy strengthens the anal canal mucosa, which can be performed alone or in combination with Doppler-guided hemorrhoidal artery ligation (DG-HAL). In this study, we compared the postoperative complications between simple mucopexy plus HAL with and without a Doppler guide.

Methods: This study was performed as a single-blinded randomized clinical trial. Patients referred to a tertiary colorectal referral clinic with grades 3 and 4 hemorrhoids who were candidates for surgical intervention entered the study. Thirty-six patients were randomly divided into 2 groups. Group A including 18 patients underwent mucopexy and DG-HAL and the other 18 patients (group B) underwent standard mucopexy and HAL without a Doppler guide. Postoperative pain score and the duration of oral analgesic consumption were recorded. Additionally, postoperative symptoms and complications were recorded and compared between the 2 methods.

Results: There was no significant difference between the 2 groups in terms of pain score and the duration of postoperative analgesic consumption as well as the incidence of postoperative complications. Besides, the primary grade of hemorrhoids was not significantly associated with recurrence, but there was a significant association between body mass index and Wexner score (WS) with recurrence. The mean WS of patients showed a significant decrease in both groups postoperatively. However, the rate of WS reduction was not remarkably different between the 2 groups.

Conclusion: Simple mucopexy with blind HAL (without Doppler guide) might be considered for the treatment of grades 3 and 4 hemorrhoids effectively.

Keywords: Colorectal surgery; Doppler-guided hemorrhoidal artery ligation; Hemorrhoid; Mucopexy; Rectal disease.

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Conflict of interest statement

Conflict of interest

No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1.
Fig. 1.
The study flowchart. DG-HAL, Doppler-guided hemorrhoidal artery ligation.
See this image and copyright information in PMC

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