A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses.

hemorrhoid complications hemorrhoid ligation hemorrhoid sclerotherapy hemorrhoids outpatient treatment review

Journal

Frontiers in surgery
ISSN: 2296-875X
Titre abrégé: Front Surg
Pays: Switzerland
ID NLM: 101645127

Informations de publication

Date de publication:
2021
Historique:
received: 24 09 2021
accepted: 02 12 2021
entrez: 27 1 2022
pubmed: 28 1 2022
medline: 28 1 2022
Statut: epublish

Résumé

Outpatient treatments are actually the techniques of choice in the management of low-grade hemorrhoidal disease. Among these, rubber band ligation (RBL) and injection sclerotherapy (IS) are the most frequently performed. Both techniques are used, without one having been determined to be superior over the other. We analyzed the studies that compare these two techniques in terms of efficacy and safety in order to offer a proposal for treatment choice. RBL seems to be most efficient in terms of symptom resolution for second-degree hemorrhoidal disease and equal or superior for treatment of third-degree disease. However, IS offers lower rates of severe post-operative pain and minor complications. Since outpatient treatments are offered to patients as painless options that allow a prompt recovery, we propose a stepwise protocol using 3% polidocanol or aluminum potassium sulfate and tannic acid IS as the first treatment option, as it has less complications, followed by RBL in cases of relapse.

Identifiants

pubmed: 35083270
doi: 10.3389/fsurg.2021.782800
pmc: PMC8784409
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

782800

Informations de copyright

Copyright © 2022 Tutino, Massani, Jospin Kamdem Mambou, Venturelli, Della Valle, Melfa, Micheli, Russo, Scerrino, Bonventre and Cocorullo.

Déclaration de conflit d'intérêts

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Références

Health Technol Assess. 2016 Nov;20(88):1-150
pubmed: 27921992
G Chir. 2017 Jan-Feb;38(1):5-14
pubmed: 28460197
Colorectal Dis. 2019 Feb;21(2):244-245
pubmed: 30485654
Colorectal Dis. 2020 Jun;22(6):650-662
pubmed: 32067353
Surgery. 2021 Aug;170(2):405-411
pubmed: 33766426
Rev Recent Clin Trials. 2021;16(1):10-16
pubmed: 32164517
World J Gastrointest Surg. 2016 Sep 27;8(9):614-620
pubmed: 27721924
Asian J Surg. 2005 Oct;28(4):241-5
pubmed: 16234072
Indian J Surg. 2013 Oct;75(5):356-60
pubmed: 24426476
Colorectal Dis. 2003 Mar;5(2):133-8
pubmed: 12780901
Niger Postgrad Med J. 2020 Jan-Mar;27(1):13-20
pubmed: 32003357
Arab J Gastroenterol. 2012 Jun;13(2):77-81
pubmed: 22980596
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Pharmacoecon Open. 2017 Sep;1(3):175-184
pubmed: 29441497
Turk J Gastroenterol. 2020 May;31(5):378-383
pubmed: 32519957
World J Emerg Surg. 2021 Sep 16;16(1):48
pubmed: 34530908
Niger Postgrad Med J. 2016 Jul-Sep;23(3):110-5
pubmed: 27623720
Gastrointest Endosc. 2004 Aug;60(2):191-5
pubmed: 15278043
J Invest Surg. 2021 Oct;34(10):1059-1065
pubmed: 32290709
Tech Coloproctol. 2020 Feb;24(2):145-164
pubmed: 31993837
World J Gastroenterol. 2007 Jan 28;13(4):585-7
pubmed: 17278225
Niger Postgrad Med J. 2020 Oct-Dec;27(4):311-316
pubmed: 33154283
Dis Colon Rectum. 1986 Dec;29(12):836-8
pubmed: 3539557
Ann Coloproctol. 2015 Jun;31(3):103-5
pubmed: 26161378
Int J Colorectal Dis. 2018 Jul;33(7):849-856
pubmed: 29680897
Rev Recent Clin Trials. 2021;16(1):5-9
pubmed: 32133966
Dis Colon Rectum. 1983 Nov;26(11):705-8
pubmed: 6354644

Auteurs

Roberta Tutino (R)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.
Chirurgia 1, Ospedale Regionale di Treviso, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.

Marco Massani (M)

Chirurgia 1, Ospedale Regionale di Treviso, Azienda ULSS 2 Marca Trevigiana, Treviso, Italy.

Leonel Jospin Kamdem Mambou (L)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Paolina Venturelli (P)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Immacolata Della Valle (I)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Giuseppina Melfa (G)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Matilde Micheli (M)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Gaia Russo (G)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Gregorio Scerrino (G)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Sebastiano Bonventre (S)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Gianfranco Cocorullo (G)

Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy.

Classifications MeSH