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Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications

BACKGROUND: Dearterialization should reduce arterial overflow to haemorrhoids. The purpose of this study was to assess the topography of haemorrhoidal arteries. METHODS: Fifty patients with haemorrhoidal disease were studied. Using endorectal ultrasonography, six sectors were identified within the l...

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Autores principales: Ratto, C, Parello, A, Donisi, L, Litta, F, Zaccone, G, Doglietto, G B
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd. 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266492/
https://www.ncbi.nlm.nih.gov/pubmed/22021046
http://dx.doi.org/10.1002/bjs.7700
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author Ratto, C
Parello, A
Donisi, L
Litta, F
Zaccone, G
Doglietto, G B
author_facet Ratto, C
Parello, A
Donisi, L
Litta, F
Zaccone, G
Doglietto, G B
author_sort Ratto, C
collection PubMed
description BACKGROUND: Dearterialization should reduce arterial overflow to haemorrhoids. The purpose of this study was to assess the topography of haemorrhoidal arteries. METHODS: Fifty patients with haemorrhoidal disease were studied. Using endorectal ultrasonography, six sectors were identified within the lower rectal circumference. Starting from the highest level (6 cm above the anorectal junction), the same procedure was repeated every 1 cm until the lowest level was reached (1 cm above the anorectal junction). Colour duplex imaging examinations identified haemorrhoidal arteries related to the rectal wall layers, and the arterial depth was calculated. RESULTS: Haemorrhoidal arteries were detected in 64·3, 66·0, 66·0, 98·3, 99·3 and 99·7 per cent of the sectors 6, 5, 4, 3, 2 and 1 cm above the anorectal junction respectively (P < 0·001). Most of the haemorrhoidal arteries were external to the rectal wall at 6 and 5 cm (97·9 and 90·9 per cent), intramuscular at 4 cm (55·0 per cent), and within the submucosa at 3, 2 and 1 cm above the anorectal junction (67·1, 96·6 and 100 per cent) (P < 0·001). The mean arterial depth decreased significantly from 8·3 mm at 6 cm to 1·9 mm at 1 cm above the anorectal junction (P < 0·001). CONCLUSION: This study demonstrated that the vast majority of haemorrhoidal arteries lie within the rectal submucosa at the lowest 2 cm above the anorectal junction. This should therefore be the best site for performing haemorrhoidal dearterialization.
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spelling pubmed-32664922012-01-27 Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications Ratto, C Parello, A Donisi, L Litta, F Zaccone, G Doglietto, G B Br J Surg Original Articles BACKGROUND: Dearterialization should reduce arterial overflow to haemorrhoids. The purpose of this study was to assess the topography of haemorrhoidal arteries. METHODS: Fifty patients with haemorrhoidal disease were studied. Using endorectal ultrasonography, six sectors were identified within the lower rectal circumference. Starting from the highest level (6 cm above the anorectal junction), the same procedure was repeated every 1 cm until the lowest level was reached (1 cm above the anorectal junction). Colour duplex imaging examinations identified haemorrhoidal arteries related to the rectal wall layers, and the arterial depth was calculated. RESULTS: Haemorrhoidal arteries were detected in 64·3, 66·0, 66·0, 98·3, 99·3 and 99·7 per cent of the sectors 6, 5, 4, 3, 2 and 1 cm above the anorectal junction respectively (P < 0·001). Most of the haemorrhoidal arteries were external to the rectal wall at 6 and 5 cm (97·9 and 90·9 per cent), intramuscular at 4 cm (55·0 per cent), and within the submucosa at 3, 2 and 1 cm above the anorectal junction (67·1, 96·6 and 100 per cent) (P < 0·001). The mean arterial depth decreased significantly from 8·3 mm at 6 cm to 1·9 mm at 1 cm above the anorectal junction (P < 0·001). CONCLUSION: This study demonstrated that the vast majority of haemorrhoidal arteries lie within the rectal submucosa at the lowest 2 cm above the anorectal junction. This should therefore be the best site for performing haemorrhoidal dearterialization. John Wiley & Sons, Ltd. 2012-01 2011-10-21 /pmc/articles/PMC3266492/ /pubmed/22021046 http://dx.doi.org/10.1002/bjs.7700 Text en Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. http://creativecommons.org/licenses/by/2.5/ Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.
spellingShingle Original Articles
Ratto, C
Parello, A
Donisi, L
Litta, F
Zaccone, G
Doglietto, G B
Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title_full Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title_fullStr Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title_full_unstemmed Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title_short Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
title_sort assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266492/
https://www.ncbi.nlm.nih.gov/pubmed/22021046
http://dx.doi.org/10.1002/bjs.7700
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