Table 2.
Doppler-guided HAL versus HAL alone with or without a mucopexy procedure: the results of 5 randomized controlled trials
| Study | Study size | Prolapse grade | Technique | Follow-up (mo) | Main result |
|---|---|---|---|---|---|
| Gupta et al. [172] (2011) | 48 | 3 | Doppler-guided HAL plus mucopexy vs. HAL without Doppler plus mucopexy | 12 | Similar hemorrhoid recurrence (P=0.939) |
| Significantly longer operative time (P<0.003) and higher postoperative pain score (P<0.002) in the Doppler group | |||||
| Schuurman et al. [171] (2012) | 82 | 2, 3 | HAL with Doppler vs. HAL without Doppler | 6 | No significant difference in symptom improvement (P>0.05) |
| More complications in the Doppler group (P<0.0005) | |||||
| Aigner et al. [173] (2016) | 40 | 3 | Doppler-guided HAL plus mucopexy vs. mucopexy alone (without previous separate HAL with a “z-stitch”) | 12 | No significant difference in hemorrhoid recurrence (P=0.274) |
| Zhai et al. [174] (2016) | 100 | 3 | Doppler-guided HAL vs. suture-fixation mucopexy | 24 | No significant difference in bleeding (P=0.45) and prolapse recurrence (P=1.00) at 12 mo; |
| Significant difference in prolapse recurrence at 24 mo in the Doppler group (P=0.030) | |||||
| Alemrajabi et al. [175] (2023) | 36 | 3, 4 | Doppler-guided HAL plus mucopexy vs. HAL without Doppler plus mucopexy | 3 | No significant difference in hemorrhoidal recurrence (P=0.486) |
HAL, hemorrhoidal artery ligation.