Onur BAYRAKTAR, Yasemin YILDIRIM, İlknur Erenler BAYRAKTAR, Mehmet KOÇAK
Turkish Journal of Colorectal Disease - 2026;36(2):62-68
Aim: Minimally invasive surgical techniques for hemorrhoidal disease aim to reduce symptom burden while preserving anorectal function and improving patient-centered outcomes. However, real-world data on both clinical severity and quality-of-life (QoL) outcomes following these procedures remain limited. Method: This single-center retrospective observational study included patients who underwent Doppler-guided hemorrhoidal artery ligation (DG-HAL) for symptomatic hemorrhoidal disease. Demographic data, operative time, and postoperative complications were recorded. Symptoms such as bleeding, soiling, prolapse, and pain were assessed both preoperatively and postoperatively using validated assessment tools; QoL was measured using the Short Form Survey-36 (SF-36) and the World Health Organization QoL-BREF (WHOQOL-BREF) questionnaire. The Hemorrhoidal Disease Symptom Score (HDSS), Wexner Score, and visual analogue scale (VAS) scores were also used to assess the symptomatic improvement. The primary outcome measures were patient satisfaction, QoL, hemorrhoidal symptom scores, and postoperative pain levels. The secondary outcomes were complete healing and recurrence rates. Results: Treatment with DG-HAL was associated with a clinically meaningful reduction in HDSS scores following the procedure. Exploratory analyses demonstrated improvements across multiple domains of WHOQOL-BREF and SF-36; VAS scores also showed improvement on postoperative day 7. Only one patient experienced a complication, namely, persistent anal pain lasting for 1 month; however, by the 2nd postoperative month, the pain had completely resolved. Two patients experienced recurrence postoperatively and subsequently underwent hemorrhoidectomy. Conclusion: In this real-world cohort, DG-HAL was associated with improvement in symptom severity and exploratory QoL measures. These findings require further prospective studies focusing on patient-centered outcomes following minimally invasive surgical treatment.
