{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:54:49Z","timestamp":1791579289967,"version":"4.3.4"},"reference-count":21,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Haemorrhoids remain a highly prevalent condition in Australia, affecting 39% of the adult Australian population. While haemorrhoidectomy remains the gold standard in the management of haemorrhoids, newer techniques such as haemorrhoid artery ligation\u2010recto anal repair (HAL\u2010RAR) are emerging as promising management modalities. We compare the efficacy of non\u2010Doppler guided (non\u2010DG) HAL\u2010RAR versus Doppler\u2010guided (DG) HAL\u2010RAR in the management of haemorrhoids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was registered with PROSPERO (CRD42022353806) and adhered to PRISMA 2020 guidelines. We conducted a systematic review using Medline, Embase and Cochrane database for comparative studies between Doppler\u2010guided HAL\u2010RAR and non\u2010Doppler\u2010guided HAL\u2010RAR in accordance with the PRISMA 2020 statement for reporting systematic reviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five studies were included in our systematic review and meta\u2010analysis. There was no clinically significant difference in operative times (SMD 0.46, 9% CI \u22123.16 0 4.08, <jats:italic>P<\/jats:italic>\u2009=\u20090.804) or post\u2010operative bleeding (<jats:italic>P<\/jats:italic>\u2009=\u20090.142) between the two groups. DG HAL\u2010RAR patients were more likely to have post\u2010operative urinary retention (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Non\u2010DG patients were less likely to experience recurrence (OR 5.12, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our review of non\u2010DG HAL\u2010RAR compared to DG HAL\u2010RAR reflects the non\u2010inferiority of the non\u2010DG HALRAR procedure. We hope that these results would provide a guide to clinicians performing HAL\u2010RAR, and would provide some cost savings for institutions who are unable to procure the necessary equipment for DG HAL\u2010RAR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.19258","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T09:49:11Z","timestamp":1730108951000},"page":"2053-2061","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Haemorrhoid artery ligation \u2013 recto anal repair (<scp>HAL<\/scp>\u2010<scp>RAR<\/scp>) blind versus Doppler: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4829-0495","authenticated-orcid":false,"given":"Amos Nepacina","family":"Liew","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery Dandenong Hospital, Monash Health  Dandenong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4223-1670","authenticated-orcid":false,"given":"Jason","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9548-9720","authenticated-orcid":false,"given":"Michelle Zhiyun","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Dandenong Hospital, Monash Health  Dandenong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeng Kwang","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery Dandenong Hospital, Monash Health  Dandenong Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1392-2480","authenticated-orcid":false,"given":"Joseph C.H.","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of General Surgery Alfred Hospital  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i22.3742"},{"key":"e_1_2_9_3_1","first-page":"398","article-title":"Management of hemorrhoidal disease","volume":"81","author":"Banov L","year":"1985","journal-title":"J. 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