الفهرس 
SURGICAL ANATOMY OF THE RECTUM, ANAL CANAL, AND PERINEUMOnly 14 pages are availabe for public view
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Abstract
T
here is no significant difference between Doppler Guided haemorrhoidal artery ligation and finger guided ligation of the haemorrhoidal artery. Both methods are feasible and could be applied as an alternative to the standard haemorrhoidectomy with great clinical outcome.
SUMMARY
H
emorrhoids are one of the commonest benign anorectal problems worldwide. They are often considered the most troublesome anal diseases. They can prolapse, dilate, bleed occasionally and cause pain and discomfort.
Numerous people are affected around the world. It is a major medical and socioeconomic problem. The etiology of hemorrhoids includes many factors such as constipation and prolonged straining.
Hemorrhoids are classified into four degrees. The first and second degrees usually require conservative or semiconservative methods. The third and fourth degrees include severe prolapse and usually require surgical intervention.
Milligan-Morgan hemorrhoidectomy has been the most popular among the various surgical techniques performed. New minimally invasive techniques have developed as an alternative to traditional and invasive procedures, one of these techniques is Doppler guided haemorrhoidal artery ligation. It has become one of the leading surgical applications in treating symptomatic hemorrhoidal diseases. Other modifications have been introduced including the ligation of haemorrhoidal artery without using the Doppler probe.
Our study included 80 patients with hemorrhoidal symptoms complaining of 2nd and 3rd degree haemorrhoids. They have been divided into two equal groups. group A the Doppler guided ligation group and group B the finger guided ligation. The rate of bleeding recurrence in DG HAL group was 2.5% and the rate of prolapse recurrence was 5% compared to 5% bleeding recurrence and prolapse recurrence 7.5% in finger guided group. There was no significant difference between the two groups in early or late postoperative complications and also no significant difference in patient satisfaction or visual analogue scale VAS of pain after surgery. In conclusion both methods are feasible and could be applied as an alternative to the standard haemorrhoidectomy with great clinical outcome.