Abstract:
BACKGROUND:Some authors, either with anatomical studies or Doppler laser flowmetric investigations have shown the blood flow to the posterior midline of the anus to be potentially deficient. This relative local ischaemia might explain pathogenesis of anal fissure, which is often located posteriorly. The aim of this study was to record the exact position of the distal branches of the superior rectal artery during Doppler-guided haemorrhoidal artery ligation-rectoanal repair (HAL-RAR) procedures with special reference to posterior distribution of the arteries. METHODS:All consecutive patients with symptomatic haemorrhoids who were treated with the HAL-RAR procedure between February 2008 and February 2014 in a single institution were included in the study. Number and position of Doppler-guided ligations were prospectively collected. Pearson's chi-squared test was used to compare artery locations. RESULTS:A total of 150 patients (75 women) with symptomatic haemorrhoids were included in the study. Median age was 53 years (range 23-83). A median of 10 ligations were placed per patient (range 3-18). A significantly lower number of cumulative arterial ligations was recorded in the posterior position (88 ligations overall, P = 0.025). CONCLUSIONS:The number of distal branches of the superior rectal artery that have been localized by the Doppler-guided HAL-RAR technique is lower at the posterior midline than in the other segments of the lower rectum. This is another evidence of the vascular deficiency at the posterior pole of the anal canal that might explain the pathogenesis of the anal fissure.
journal_name
ANZ J Surgjournal_title
ANZ journal of surgeryauthors
Trilling B,Mancini A,Reche F,Pflieger H,Sage PY,Faucheron JLdoi
10.1111/ans.15143subject
Has Abstractpub_date
2019-07-01 00:00:00pages
E288-E291issue
7-8eissn
1445-1433issn
1445-2197journal_volume
89pub_type
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journal_title:ANZ journal of surgery
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journal_title:ANZ journal of surgery
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journal_title:ANZ journal of surgery
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更新日期:2013-01-01 00:00:00
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journal_title:ANZ journal of surgery
pub_type: 杂志文章,评审
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更新日期:2020-04-01 00:00:00
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journal_title:ANZ journal of surgery
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更新日期:2005-11-01 00:00:00
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journal_title:ANZ journal of surgery
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更新日期:2020-09-01 00:00:00