ULTRASOUND-GUIDED TRANSANAL HEMORRHOIDAL DEARTERIALIZATION. ONE YEAR OF EXPERIENCE IN A HOSPITAL CENTER IN URUGUAY

Abstract

INTRODUCTION

Within the group of anal and perianal pathology, hemorrhoidal pathology is the most frequent.

There are multiple therapeutic options for symptomatic hemorrhoidal disease, from topical medical treatments to increasingly complex surgical treatments. Doppler-guided ligation of hemorrhoidal arterial pedicles, also known as dearterialization associated or not with mucopexy, is a promising non-resective method.

DESIGN AND METHODS

This is a prospective, observational and descriptive study developed at the British Hospital of Uruguay in the period between January 2020 and January 2021. It involves all patients undergoing guided dearterialization with a Doppler probe incorporated into a proctoscope (associated with mucopexy in cases of prolapse) using the A.M.I Trilogy equipment.

RESULTS

A total of 50 patients were included. The average age of the analyzed population was 50 years. The distribution by sex was 56% male and 44% female. The indication was mainly in those classified as grade III (66%) with lower figures of grade II and IV. In 46 (92%) patients with grade III and IV hemorrhoids, the procedure was completed with rectal mucosa pexy up to 1 cm proximal to the cryptopapillary line. In the remaining 4 cases (8%) of grade II hemorrhoids, only dearterialization was performed.

CONCLUSIONS

In our center, the surgical technique used is reproducible, safe and reliable, achieving surgical times similar to those of the international literature with favorable results.

 Finally, patient satisfaction with the procedure was very high.