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Reviews on Recent Clinical Trials

Editor-in-Chief

ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

Review Article

Outpatient Treatment of Hemorrhoidal Disease: The Alternative Way to Treat Hemorrhoidal Disease in a Simple, Safe and Effective Manner

Author(s): Roberta Tutino*, Giuseppe Salamone, Paolino De Marco, Gianfranco Cocorullo and Gaspare Gulotta

Volume 16, Issue 1, 2021

Published on: 05 March, 2020

Page: [5 - 9] Pages: 5

DOI: 10.2174/1574887115666200305150029

Price: $65

Abstract

Background: Hemorrhoidal disease is a widespread problem in healthy working patients. The traditional surgical approaches cause a loss of several working days related to the post-- operative course that is often painful. To avoid these problems while offering a symptoms resolution in patients with low degrees hemorrhoids, the non-surgical treatments are nowadays largely proposed in proctological clinics.

Methods: We resume the recent literature on the issue to offer a practical and easy to use guide for clinicians.

Results: Rubber band ligation, injection sclerotherapy and infrared coagulation are cost effective, safe and effective treatments for patients with II- and III-degree hemorrhoids. Relapses are commons even if the procedures can be repeated until symptoms resolution. IV-degree hemorrhoids are not suitable of these treatments.

Conclusion: The proctological clinics must evaluate the quality of life offered to patients and discuss with them the appropriate treatment in order to select the most appropriate one for symptoms resolution and disease cure. Less is not always the best but can be an alternative to be offered.

Keywords: Hemorrhoid ligation, hemorrhoid sclerotherapy, hemorrhoid infrared coagulation, hemorrhoid complications, proctological clinics, outpatient treatment.

Graphical Abstract
[1]
Rivadeneira DE, Steele SR, Ternent C, Chalasani S, Buie WD, Rafferty JL. Standards practice task force of the american society of colon and rectal surge. Practice parameters for the management of hemorrhoids (revised 2010). Dis Colon Rectum 2011; 54(9): 1059-64.
[http://dx.doi.org/10.1097/DCR.0b013e318225513d] [PMID: 21825884]
[2]
Gallo G, Martellucci J, Sturiale A, et al. Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Tech Coloproctol 2020; 24(2): 145-64.
[http://dx.doi.org/10.1007/s10151-020-02149-1] [PMID: 31993837]
[3]
Cocorullo G, Tutino R, Falco N, et al. Rectal bleeding and prolapse… not always benign diseases rather anal cancer. The importance of a correct decision making since primary care. G Chir 2016; 37(3): 133-5.
[PMID: 27734798]
[4]
Gallo G, Realis Luc A, Clerico G, Trompetto M. Diathermy excisional haemorrhoidectomy - still the gold standard - a video vignette. Colorectal Dis 2018; 20(12): 1154-6.
[http://dx.doi.org/10.1111/codi.14430] [PMID: 30298969]
[5]
Hite N, Klinger AL, Miller P, et al. Clopidogrel bisulfate (Plavix) does not increase bleeding complications in patients undergoing rubber band ligation for symptomatic hemorrhoids. J Surg Res 2018; 229: 230-3.
[http://dx.doi.org/10.1016/j.jss.2018.04.004] [PMID: 29936995]
[6]
Alshreef A, Wailoo AJ, Brown SR, et al. Cost-effectiveness of haemorrhoidal artery ligation versus rubber band ligation for the treatment of grade II-III haemorrhoids: Analysis using evidence from the hubBLe trial. Pharmacoeconom Open 2017; 1(3): 175-84.
[http://dx.doi.org/10.1007/s41669-017-0023-6] [PMID: 29441497]
[7]
Gagloo MA, Hijaz SW, Nasir SA, et al. Comparative study of hemorrhoidectomy and rubber band ligation in treatment of second and third degree hemorrhoids in kashmir. Indian J Surg 2013; 75(5): 356-60.
[http://dx.doi.org/10.1007/s12262-012-0498-4] [PMID: 24426476]
[8]
van Tol RR, Bruijnen MPA, Melenhorst J, van Kuijk SMJ, Stassen LPS, Breukink SO. A national evaluation of the management practices of hemorrhoidal disease in the Netherlands. Int J Colorectal Dis 2018; 33(5): 577-88.
[http://dx.doi.org/10.1007/s00384-018-3019-5] [PMID: 29546558]
[9]
Awad AE, Soliman HH, Saif SALA, Darwish AM, Mosaad S, Elfert AA. A prospective randomised comparative study of endoscopic band ligation versus injection sclerotherapy of bleeding internal haemorrhoids in patients with liver cirrhosis. Arab J Gastroenterol 2012; 13(2): 77-81.
[http://dx.doi.org/10.1016/j.ajg.2012.03.008] [PMID: 22980596]
[10]
Jutabha R, Jensen DM, Chavalitdhamrong D. Randomized prospective study of endoscopic rubber band ligation compared with bipolar coagulation for chronically bleeding internal hemorrhoids. Am J Gastroenterol 2009; 104(8): 2057-64.
[http://dx.doi.org/10.1038/ajg.2009.292] [PMID: 19513028]
[11]
Ricci MP, Matos D, Saad SS. Rubber band ligation and infrared photocoagulation for the outpatient treatment of hemorrhoidal disease. Acta Cir Bras 2008; 23(1): 102-6.
[http://dx.doi.org/10.1590/S0102-86502008000100016] [PMID: 18278400]
[12]
Aram FO. Rubber band ligation for hemorrhoids: an office experience. Indian J Surg 2016; 78(4): 271-4.
[http://dx.doi.org/10.1007/s12262-015-1353-1] [PMID: 27574343]
[13]
Azizi R, Rabani-Karizi B, Taghipour MA. Comparison between Ultroid and rubber band ligation in treatment of internal hemorrhoids. Acta Med Iran 2010; 48(6): 389-93.
[PMID: 21287479]
[14]
Cazemier M, Felt-Bersma RJ, Cuesta MA, Mulder CJ. Elastic band ligation of hemorrhoids: Flexible gastroscope or rigid proctoscope? World J Gastroenterol 2007; 13(4): 585-7.
[http://dx.doi.org/10.3748/wjg.v13.i4.585] [PMID: 17278225]
[15]
Ramzisham AR, Sagap I, Nadeson S, Ali IM, Hasni MJ. Prospective randomized clinical trial on suction elastic band ligator versus forceps ligator in the treatment of haemorrhoids. Asian J Surg 2005; 28(4): 241-5.
[http://dx.doi.org/10.1016/S1015-9584(09)60353-5] [PMID: 16234072]
[16]
Wehrmann T, Riphaus A, Feinstein J, Stergiou N. Hemorrhoidal elastic band ligation with flexible videoendoscopes: A prospective, randomized comparison with the conventional technique that uses rigid proctoscopes. Gastrointest Endosc 2004; 60(2): 191-5.
[http://dx.doi.org/10.1016/S0016-5107(04)01551-2] [PMID: 15278043]
[17]
Kanellos I, Goulimaris I, Christoforidis E, Kelpis T, Betsis D. A comparison of the simultaneous application of sclerotherapy and rubber band ligation, with sclerotherapy and rubber band ligation applied separately, for the treatment of haemorrhoids: A prospective randomized trial. Colorectal Dis 2003; 5(2): 133-8.
[http://dx.doi.org/10.1046/j.1463-1318.2003.00395.x] [PMID: 12780901]
[18]
Brown SR, Tiernan JP, Watson AJM, et al. HubBLe Study team. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): A multicentre, open-label, randomised controlled trial. Lancet 2016; 388(10042): 356-64.
[http://dx.doi.org/10.1016/S0140-6736(16)30584-0] [PMID: 27236344]
[19]
Cocorullo G, Tutino R, Falco N, et al. The non-surgical management for hemorrhoidal disease. A systematic review. G Chir 2017; 38(1): 5-14.
[http://dx.doi.org/10.11138/gchir/2017.38.1.005] [PMID: 28460197]
[20]
Trompetto M, Clerico G, Cocorullo GF, et al. Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement. Tech Coloproctol 2015; 19(10): 567-75.
[http://dx.doi.org/10.1007/s10151-015-1371-9] [PMID: 26403234]
[21]
Albuquerque A. Rubber band ligation of hemorrhoids: A guide for complications. World J Gastrointest Surg 2016; 8(9): 614-20.
[http://dx.doi.org/10.4240/wjgs.v8.i9.614] [PMID: 27721924]
[22]
Beattie GC, Rao MM, Campbell WJ. Secondary haemorrhage after rubber band ligation of haemorrhoids in patients taking clopidogrel--a cautionary note. Ulster Med J 2004; 73(2): 139-41.
[PMID: 15651778]
[23]
Chau NG, Bhatia S, Raman M. Pylephlebitis and pyogenic liver abscesses: A complication of hemorrhoidal banding. Can J Gastroenterol 2007; 21(9): 601-3.
[http://dx.doi.org/10.1155/2007/106946] [PMID: 17853956]
[24]
Tejirian T, Abbas MA. Bacterial endocarditis following rubber band ligation in a patient with a ventricular septal defect: report of a case and guideline analysis. Dis Colon Rectum 2006; 49(12): 1931-3.
[http://dx.doi.org/10.1007/s10350-006-0769-x] [PMID: 17080276]
[25]
Sim HL, Tan KY, Poon PL, Cheng A, Mak K. Life-threatening perineal sepsis after rubber band ligation of haemorrhoids. Tech Coloproctol 2009; 13(2): 161-4.
[http://dx.doi.org/10.1007/s10151-008-0435-5] [PMID: 18679564]
[26]
Yano T, Asano M, Tanaka S, Oda N, Matsuda Y. Prospective study comparing the new sclerotherapy and hemorrhoidectomy in terms of therapeutic outcomes at 4 years after the treatment. Surg Today 2014; 44(3): 449-53.
[http://dx.doi.org/10.1007/s00595-013-0564-y] [PMID: 23543083]
[27]
Miyamoto H, Hada T, Ishiyama G, Ono Y, Watanabe H. Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study. World J Hepatol 2016; 8(20): 844-9.
[http://dx.doi.org/10.4254/wjh.v8.i20.844] [PMID: 27458504]
[28]
Tokunaga Y, Sasaki H, Saito T. Evaluation of sclerotherapy with a new sclerosing agent and stapled hemorrhoidopexy for prolapsing internal hemorrhoids: Retrospective comparison with hemorrhoidectomy. Dig Surg 2010; 27(6): 469-72.
[http://dx.doi.org/10.1159/000320321] [PMID: 21063123]
[29]
Moser KH, Mosch C, Walgenbach M, et al. Efficacy and safety of sclerotherapy with polidocanol foam in comparison with fluid sclerosant in the treatment of first-grade haemorrhoidal disease: a randomised, controlled, single-blind, multicentre trial. Int J Colorectal Dis 2013; 28(10): 1439-47.
[http://dx.doi.org/10.1007/s00384-013-1729-2] [PMID: 23775099]
[30]
Yano T, Yano K. Comparison of injection sclerotherapy between 5% phenol in almond oil and aluminum potassium sulfate and tannic acid for grade 3 hemorrhoids. Ann Coloproctol 2015; 31(3): 103-5.
[http://dx.doi.org/10.3393/ac.2015.31.3.103] [PMID: 26161378]
[31]
Akindiose C, Alatise OI, Arowolo OA, Agbakwuru AE. Evaluation of two injection sclerosants in the treatment of symptomatic haemorrhoids in Nigerians. Niger Postgrad Med J 2016; 23(3): 110-5.
[http://dx.doi.org/10.4103/1117-1936.190347] [PMID: 27623720]
[32]
Lobascio P, Minafra M, Laforgia R, Giove C, Trompetto M, Gallo G. The use of sclerotherapy with polidocanol foam in the treatment of second-degree haemorrhoidal disease - a video vignette. Colorectal Dis 2019; 21(2): 244-5.
[PMID: 30485654]
[33]
Yano T, Nogaki T, Asano M, Tanaka S, Kawakami K, Matsuda Y. Outcomes of case-matched injection sclerotherapy with a new agent for hemorrhoids in patients treated with or without blood thinners. Surg Today 2013; 43(8): 854-8.
[http://dx.doi.org/10.1007/s00595-012-0365-8] [PMID: 23052752]
[34]
Takano M, Iwadare J, Ohba H, et al. Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision. Int J Colorectal Dis 2006; 21(1): 44-51.
[http://dx.doi.org/10.1007/s00384-005-0771-0] [PMID: 15843937]
[35]
Yuksel BC, Armagan H, Berkem H, Yildiz Y, Ozel H, Hengirmen S. Conservative management of hemorrhoids: a comparison of venotonic flavonoid micronized purified flavonoid fraction (MPFF) and sclerotherapy. Surg Today 2008; 38(2): 123-9.
[http://dx.doi.org/10.1007/s00595-007-3582-9] [PMID: 18239868]
[36]
Tomiki Y, Ono S, Aoki J, et al. Treatment of internal hemorrhoids by endoscopic sclerotherapy with aluminum potassium sulfate and tannic acid. Diagn Ther Endosc 2015; 2015: 517690.
[http://dx.doi.org/10.1155/2015/517690] [PMID: 26246785]
[37]
Bullock N. Impotence after sclerotherapy of haemorrhoids: Case reports. BMJ 1997; 314(7078): 419.
[http://dx.doi.org/10.1136/bmj.314.7078.419] [PMID: 9040388]
[38]
Schulte T, Fändrich F, Kahlke V. Life-threatening rectal necrosis after injection sclerotherapy for haemorrhoids. Int J Colorectal Dis 2008; 23(7): 725-6.
[http://dx.doi.org/10.1007/s00384-007-0402-z] [PMID: 18043926]
[39]
Yang P, Wang YJ, Li F, Sun JB. Hemorrhoid sclerotherapy with the complication of abdominal compartment syndrome: Report of a case. Chin Med J (Engl) 2011; 124(12): 1919-20.
[PMID: 21740855]
[40]
Yoshikawa K, Kawashima R, Hirose Y, et al. Liver injury after aluminum potassium sulfate and tannic acid treatment of hemorrhoids. World J Gastroenterol 2017; 23(27): 5034-40.
[http://dx.doi.org/10.3748/wjg.v23.i27.5034] [PMID: 28785156]
[41]
Serra R, Gallelli L, Grande R, et al. Hemorrhoids and matrix metalloproteinases: A multicenter study on the predictive role of biomarkers. Surgery 2016; 159(2): 487-94.
[http://dx.doi.org/10.1016/j.surg.2015.07.003] [PMID: 26263832]
[42]
Dimitroulopoulos D, Tsamakidis K, Xinopoulos D, Karaitianos I, Fotopoulou A, Paraskevas E. Prospective, randomized, controlled, observer-blinded trial of combined infrared photocoagulation and micronized purified flavonoid fraction versus each alone for the treatment of hemorrhoidal disease. Clin Ther 2005; 27(6): 746-54.
[http://dx.doi.org/10.1016/j.clinthera.2005.06.016] [PMID: 16117981]
[43]
Marques CFS, Nahas SC, Nahas CSR, Sobrado CW Jr, Habr-Gama A, Kiss DR. Early results of the treatment of internal hemorrhoid disease by infrared coagulation and elastic banding: a prospective randomized cross-over trial. Tech Coloproctol 2006; 10(4): 312-7.
[http://dx.doi.org/10.1007/s10151-006-0299-5] [PMID: 17115317]
[44]
Ahmad A, Kant R, Gupta A. Comparative Analysis of Doppler Guided Hemorrhoidal Artery Ligation (DG-HAL) & Infrared Coagulation (IRC) in management of hemorrhoids. Indian J Surg 2013; 75(4): 274-7.
[http://dx.doi.org/10.1007/s12262-012-0444-5] [PMID: 24426452]
[45]
Gupta PJ. Infrared coagulation versus rubber band ligation in early stage hemorrhoids. Braz J Med Biol Res 2003; 36(10): 1433-9.
[http://dx.doi.org/10.1590/S0100-879X2003001000022] [PMID: 14502378]

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