Hemorrhoid artery ligation and recto-anal repair treatment for hemorrhoid: a case series

Abstract

Introduction: Hemorrhoidal artery ligation (HAL) combined with recto-anal repair (RAR), is an alternative technique for the treatment of hemorrhoid disease from grade I to IV. HAL-RAR involves anoscope with a Doppler to identify the position and depth of rectal arterial, which can be selectively ligated 3-4 cm above the dentate line. This technique has been proposed as a practical, easy to learn, minimally invasive, and safe.Case: 5 cases in Husada Hospital Central of Jakarta with hemorrhoid grade IV underwent HAL-RAR. The initial result, 14th day post-operative follow up, early benefits, and postoperative complications that most affected by HAL-RAR technique will be analyzed. Treatment confirmed 5 cases showed less postoperative pain measured by visual analog scale (VAS), fewer complications, on the 14th day follow up the main complication there was only one case with residual protrusion in initial follow up resolved four weeks later, and well-controlled of manifestation. All patients were satisfied with the result.Conclusion: HAL-RAR is an easy to learn technique, useful to perform, less post-operative pain, and gives fewer complications as treatment of advanced hemorrhoid disease. But, needed more cases and a longer follows up to analyze the late complications and recurrence.