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Paper Information

Journal:   KOWSAR MEDICAL JOURNAL   SUMMER 2007 , Volume 12 , Number 2; Page(s) 169 To 174.
 
Paper: 

POST OPERATIVE PAIN AND PATIENTS SATISFACTION IN DOPPLER GUIDED ‎HEMORRHOIDAL ARTERY LIGATION (DG-HAL) VS. CONVENTIONAL SURGICAL ‎HEMORRHOIDECTOMY

 
 
Author(s):  TOULIAT KASHANI S.M.*, BANGASH M.N., MOUSAVI NAEINI S.M., SAEIDI M.R.
 
* DEPARTMENT OF SURGERY, FACULTY OF MEDICINE, BAQIYATALLAH (A.S.) UNIVERSITY OF MEDICAL SCIENCE, TEHRAN. I.R., IRAN
 
Abstract: 

Objective: Hemorrhoidal disease is a common anorectal condition which surgical hemorrhoidectomy remains its standard treatment. Post-operative pain is a common and important problem following hemorrhoidectomy. Doppler guided-hemorrhoidal artery ligation (DG-HAL) is a relatively new method which is based on selective ligation of the arteries supplying blood to the piles. In this study we compared the post-operative pain and patients satisfication of conventional hemorrhoidectomy with DG-HAL.  
Materials and Methods: This is a radomized clinical trail which carried out on 51 consecutive cases which were admited to Baghiyatallah and Day surgical day clinic from 2004 to 2006. Patients randomized into two groups: group A (n=25) were treated with conventional hemorrhoidectomy and group B (n=26) with Doppler-guided hemorrhoid artery ligation. Post-operative pain assessed by visual analog scale (VAS) and scored between 0-10. Data analyzed using SPSS 11.5 for windows and p values < 0.05 considered statistically significant.
Results: Among 51 studied cases, 25 cases treated with DG-HAL method and 26 cases treated by conventional surgery. The average age of patients was 42.29 years and 82.4% were male and 17.6% were female. The average pain scores of patent in the 1st, 2nd and 3rd post-operative day and 1st and 2nd week post operatively were respectively 1.92, 1.08, 0.36, 0.04 and 0.04 for DG-HAL group and 6.58, 6.31, 5.81, 4.58, 2.85 for surgery group. 80% of cases in DG-HAL group returned to their usual daily activities in first 3 days after intervention and in surgery group 15.4% asumed their usual activites in the same period (P value<0.05). The rate of satisfaction in terms of complete satisfaction in HAL group versus conventional hemorrhoidectomy was 76% and 50% respectively; relative satisfaction was 20% versus 38.9% and no satisfaction 4% versus 7.7%.
Conclusion: In comparison with conventional hemorroidectomy, post operative pain in HAL technique was less than conventional hemorrhoidectomy and patients satisfication in later tecnique was beter. Return to usual daily activities in HAL group was also considerabley shorter than conventional hemorrhoidectomy.

 
Keyword(s): HEMORRHOIDECTOMY, DOPPLER GUIDED-HEMORRHOIDAL ARTERY LIGATION (DG-HAL), POST OPERATIVE PAIN, PATIENT SATISFICATION
 
References: 
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