- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04731064
Recurrence Rate of Hemorrhoidal Disease at 10 Years and More After HAL Doppler or HAL-RAR Intervention (HALTY)
Recurrence Rate of Hemorrhoidal Disease at 10 Years and More After Hemorrhoidal Artery Ligation (HAL)
The treatment of hemorrhoidal disease involves both instrumental and surgical techniques (hemorrhoidectomy and hemorrhoidopexy). In 1995, a Japanese author proposed a new treatment technique for stage II (spontaneous reintegration prolapse) or III (digital reintegration prolapse) disease, based on Doppler identification of low perirectal arteries followed by their ligation, via a specific windowed rectoscope. Later, a further modification appeared, allowing patients to be treated at more advanced stages, adding vertical mucopexy to the ligatures along the main bundles.
The pathophysiology of hemorrhoidal disease is based on a vascular theory (opening of arteriovenous shunts) and on a mechanical theory (distension of the supporting tissue). Hemorrhoidectomy responds to the first, hemorrhoidopexy to the second. The HAL (Hemorrhoidal Artery Ligation) - RAR (Recto-Anal Repair) technique seeks to treat both vascular (by ligation of the nourishing arteries) and mechanical (by mucopexy of prolapsed bundles) components. The technique first spread to Germany, Russia, Italy, Spain, Australia and England. It has been popularized in France by some authors.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The treatment of hemorrhoidal disease involves both instrumental and surgical techniques (hemorrhoidectomy and hemorrhoidopexy). In 1995, a Japanese author proposed a new treatment technique for stage II (spontaneous reintegration prolapse) or III (digital reintegration prolapse) disease, based on Doppler identification of low perirectal arteries followed by their ligation, by a specific windowed rectoscope. Later, a further modification appeared, allowing patients to be treated at more advanced stages, adding vertical mucopexy to the ligatures along the main bundles.
Physiopathological basis of HAL Doppler The pathophysiology of hemorrhoidal disease is based on a vascular theory (opening of arteriovenous shunts) and on a mechanical theory (distension of the supporting tissue). Hemorrhoidectomy responds to the first, hemorrhoidopexy to the second. The HAL (Hemorrhoidal Arttery Ligation) - RAR (Recto-Anal Repair) technique seeks to treat both vascular components (by ligation of the nourishing arteries) and mechanical (by mucopexy of prolapsed bundles). The technique first spread to Germany, Russia, Italy, Spain, Australia and England. It was popularized in France by some authors.
Description of the operation The patient is operated on in the perineal first position, under general anesthesia or under locoregional or even local anesthesia. Most of the time, the procedure is performed on an outpatient basis, after rectal preparation with a simple enema.4,5 The equipment (there are several types) for HAL comprises a transparent disposable rectoscope provided near its end with a centimeter window through which the x-point ligatures of slowly absorbable 2/0 thread will be made. It contains a light source facilitating the exposure of the internal surface of the rectum and a Doppler transducer secured to the base of the rectoscope containing the Doppler system itself. The assembly is connected to a generator which will transmit the Doppler noises to the surgeon. A printer on the generator allows ligatures to be mapped and the depth of linked arteries to be noted.6 The rest of the equipment includes a needle holder, knot pusher, scissors and dissecting forceps to dab the surgical site if necessary.2 The material for HAL with mucopexy is identical, except for the disposable rectoscope which is much more indented at its end and on one side (and at the time of arterial ligation, covered by a metal or opalescent jacket leaving a window), so as to be able to carry out a vertical overlock in the lower rectum, above the package that the operator intends to treat. It is thus possible to make one or more mucopexies depending on the operative findings.
The procedure takes about 20 to 30 minutes. Two circumferential explorations are performed at the level of the lower rectum, approximately 25 and 40 mm above the pectinate line. Patients on anticoagulant or antiplatelet therapy can be operated using this technique, since there is no wound. The patient leaves the same day with paracetamol on demand, without special care at home.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Giorgia Mastronicola, MD
- Phone Number: 0033476767079
- Email: GMastronicola@chu-grenoble.fr
Study Contact Backup
- Name: Fatah TIDADINI
- Phone Number: 0033476767079
- Email: FTidadini@chu-grenoble.fr
Study Locations
-
-
-
Grenoble, France
- Recruiting
- CHU Grenoble-Alpes
-
Contact:
- Jean-Luc FAUCHERON, MD-PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patient operated for hemorrhoidal disease for 10 or more
- Age 18 and over
- Informed patients
Exclusion Criteria:
- Patient opposition
- Minor patient
Study Plan
How is the study designed?
Design Details
- Observational Models: Other
- Time Perspectives: Other
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
The rate of recurrence leading to a re-intervention within 10 years of the intervention.
Time Frame: 10 years
|
10 years
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Giorgia Mastronicola, CHU Grenoble Alpes
- Study Director: Jean Luc FAUCHERON, MD-PhD, CHU Grenoble Alpes
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 38RC20.283
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Hemorrhoidal Disease
-
Hospital Israelita Albert EinsteinCompletedHemorrhoidal DiseaseBrazil
-
Assistance Publique Hopitaux De MarseilleCompletedHemorrhoidal DiseaseFrance
-
Amalia Fleming General HospitalSismanoglio - Amalia Fleming General HospitalCompletedHemorrhoidal Disease
-
Hospital de Clinicas de Porto AlegreUnknownHemorrhoidal DiseaseBrazil
-
Cathay General HospitalCompletedHemorrhoids | Haemorrhoids | Piles | Hemorrhoidal DiseaseTaiwan
-
Center of Endourology "Endocenter"CompletedHemorrhoids | Hemorrhoid Pain | Hemorrhoidal BleedingRussian Federation
-
ProgenaBiomeRecruitingAlzheimer Disease | Alzheimer Disease, Early Onset | Alzheimer Disease, Late Onset | Alzheimer Disease 1 | Alzheimer Disease 2 | Alzheimer Disease 3 | Alzheimer Disease 4 | Alzheimer Disease 7 | Alzheimer Disease 17 | Alzheimer Disease 5 | Alzheimer Disease 6 | Alzheimer Disease 8 | Alzheimer Disease 10 | Alzheimer... and other conditionsUnited States
-
Cognito Therapeutics, Inc.RecruitingCognitive Impairment | Dementia | Alzheimer Disease | Mild Cognitive Impairment | Cognitive Decline | Alzheimer Disease, Early Onset | Alzheimer Disease, Late Onset | MCI | Dementia Alzheimers | Mild Dementia | Dementia of Alzheimer Type | Cognitive Impairment, Mild | Alzheimer Disease 1 | Dementia, Mild | Alzheimer... and other conditionsUnited States
-
Academisch Medisch Centrum - Universiteit van Amsterdam...CelltrionRecruitingBowel Disease | Inflammatory Disease | Disease CrohnNetherlands
-
Abbott Medical DevicesCompletedCoronary Artery Disease | Coronary Heart Disease | Peripheral Vascular Disease | Peripheral Artery Disease | Arterial Occlusive DiseaseUnited States
Clinical Trials on HAL (Hemorrhoidal Artery Ligation) - RAR (Recto-Anal Repair)
-
Amalia Fleming General HospitalSismanoglio - Amalia Fleming General HospitalCompletedHemorrhoidal Disease
-
Cantonal Hospital of St. GallenActive, not recruitingHemorrhoidsSwitzerland
-
Hospital PlatóCompletedPain, Postoperative | HemorrhoidsSpain
-
Universidade do PortoCompleted
-
Universitair Ziekenhuis BrusselNot yet recruiting
-
ElsanRecruiting