Twee nieuwe behandelingen van hemorroïden
Open

dopplergeleide ligering van hemorroïdale arteriën en geniete anopexie
Stand van zaken
19-01-2010
J.W.A. (Pim) Burger, Erik Hans Eddes, Michael F. Gerhards, Pascal G. Doornebosch en Eelco J.R. de Graaf

Two new treatments for haemorrhoids. Doppler-guided haemorrhoidal artery ligation and stapled anopexy

  • Haemorrhoids occur in approximately 30% of the population.

  • Commonly occurring complaints include blood loss, pruritus, hygiene problems and soiling.

  • A high-fibre diet, with dietary-fiber supplementation if required, often resolves the symptoms.

  • When symptoms are not resolved, the next step is rubber band ligation: a safe and easy procedure.

  • In the long term, the result of rubber band ligation is often unsatisfactory. Haemorrhoidectomy was formerly the only alternative.

  • Haemorrhoidectomy can be accompanied by serious complications, such as disabling pain and incontinence. Haemorrhoidectomy was therefore considered obsolete by the Dutch Institute for Healthcare Improvement (CBO) guideline of 1994.

  • Today new operative procedures are available: Doppler-guided haemorrhoidal artery ligation (DG-HAL) and stapled anopexy.

  • Both techniques are safe and yield good results. Moreover, these techniques cause little postoperative pain.

  • DG-HAL and stapled anopexy offer an alternative for patients whose symptoms are not resolved by dietary-fiber supplementation and rubber band ligation.