Comparative Study between Doppler-Guided Haemorrhoidal Artery Ligation (HAL) and Conventional Haemorrhoidectomy for Treatment of III& IV Degree Haemorrhoids

Abstract

Background: Haemorrhoidal disease is probably the most frequent reason for consultation in proctology with an estimated prevalence about 4.4%. The gold standard treatment is still excisional hemorrhoidectomy, which is considered a safe and definitive method. Objective: The study was designed to compare the clinical and functional outcome of Doppler-guided (DG) haemorrhoidal artery ligation (HAL) and conventional haemorrhoidectomy for treatment of grade III & IV haemorrhoids. Patients and methods: This study was conducted on 60 patients, divided into two groups: group A included 30 patients that were operated upon through the conventional haemorrhoidectomy and group B include 30 patients that were operated upon through Doppler-guided haemorrhoidal artery ligation (DG- HAL), and comparison between two groups as regard outcomes and complications. Results: It was found from this study that DG- HAL is a painless, easily learned, and minimally invasive therapeutic technique that offers a good alternative to all other known treatments of symptomatic hemorrhoids. During the postoperative check-up 6 weeks after the procedure, scar tissue that had been firmly connected to the underlying tissue structure was seen in areas where ligatures had been placed. Conclusion: Using DG-HAL complications are comparable with those associated with other methods, with no severe complications. The DG-HAL procedure is synonymous with a high level of patient comfort and is perfect for outpatient treatment.