Doppler-guided hemorrhoidal dearterialization. Technical evolution and results of treatment (review)

Hemorrhoidectomy is considered as the “gold standard” for hemorrhoidal disease, but is associated with a long rehabilitation period. For this reason, 20 years ago, an innovative method for hemorrhoids was developed – Doppler-guided hemorrhoidal dearterialization. The aim of the work is to analyze the literary data of the use of Doppler-guided dearterialization for hemorrhoidal disease, the technical evolution of the method and the analysis of the results. An analysis of the literature shows that Dopplerguided dearterialization is a safe and effective method for hemorrhoidal disease. The combination of dearterialization with transanal mucopexy improves outcomes in patients with hemorrhoids III and IV stages. However, good results can be obtained not in all forms of hemorrhoidal disease. The efficacy depends on the peculiar features of the anorectal zone vascularization, the degree of destruction of the suspensory ligaments of the internal hemorrhoidal plexus and the degree of enlargement of the external hemorrhoid plexus. The adequacy of the dearterialization and mucopexy requires an objective control for assessment of the procedure.