Ligation under vision in the management of symptomatic hemorrhoids: A preliminary experience

Aim: To evaluate the surgical outcomes of 47 patients who underwent hemorrhoidal arterial ligation under vision (LUV) for symptomatic Grade II and Grade III hemorrhoids. Methods: A total of 47 patients who underwent LUV between May 2005 and February 2009 were analyzed retrospectively. The patients were evaluated with regard to demographic data, grade of the disease, symptoms, medical and/or surgical treatment previously received, operation time, pain scores, analgesic requirement, length of hospital stay, and complications related to the procedure. Results: The study population (n = 47) included 31 (65.9%) men and 16 (34.1%) women with a median age of 37.4 ± 11.7 (range, 19–63) years. Of these 47 patients, 18 (38.3%) patients had Grade II hemorrhoidal disease (HD) and 29 (61.7%) patients had Grade III HD. On average, six ligatures (range, 3–8) were used. The mean operation time was 27 ± 4.8 (range, 15–35) minutes. No major complication that required surgical intervention occurred in the early postoperative period for any of the patients except for two patients with rectal submucosal hematoma. The mean hospital stay was 1.2 ± 0.65 (range, 1–4) days. The median follow-up period was 21.5 ± 7.7 (range, 12–44) months. At the last follow-up, 38 (80.8%) patients remained asymptomatic; two (4.2%) patients with Grade II HD and four (8.5%) patients with Grade III HD were still suffering from bleeding but with a reduction in the frequency; prolapsed hemorrhoids were detected only in three (6.3%) patients. Conclusion: LUV is a safe and easily applied alternative technique with low postoperative complications for the surgical treatment of symptomatic Grade II and III HD