Abstract
Purpose
Despite all developments in recent years, the choice of an adequate treatment for hemorrhoids remains a problem. Hemorrhoidal artery ligation and recto-anal repair (HAL-RAR) is a nonexcisional surgical technique for the treatment of hemorrhoids, consisting in the ligation of the distal branches of the superior rectal artery, resulting in a reduction of blood flow and decongestion of the hemorrhoidal plexus. The aim of this study was to present the early experience of treating hemorrhoids with HAL-RAR.
Methods
Between December 2008 and November 2009, 70 consecutive patients with symptomatic hemorrhoids were treated with HAL-RAR. The patients underwent sonographic identification and suture ligation of 4 to 8 terminal branches of the superior rectal artery above the dentate line.
Results
There were 33 males and 37 females (mean age, 49.72±14.1 years). The mean operative time was 43.8 minutes (25~80 min). Most patients (=61, 87%) were without any complaint upon follow-up at 1 week. Nine patients presented with early complication: isolated pain in 1, anemia in 1, isolated bleeding in 1, voiding difficulty (over 1 day) in 2 and tenesmus (over 2 weeks) in 4.
Figures and Tables
Fig. 2
Schematic illustration of the hemorrhoidal artery ligation (HAL)-Doppler proctoscope in the anal canal during ligation.
![jkss-79-116-g002](/upload/SynapseData/ArticleImage/0037jkss/jkss-79-116-g002.jpg)
Fig. 3
Preoperative appearance of anus of 58-year-old patient suffering from protruding hemorrhoid & mucosal edema.
![jkss-79-116-g003](/upload/SynapseData/ArticleImage/0037jkss/jkss-79-116-g003.jpg)
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