The non-surgical treatments for hemorrhoids are cost and time-saving techniques usually performed in patients suffering early hemorrhoidal disease. The most used are rubber band ligation (RBL), injection sclerotherapy (IS), and infrared coagulation (IRC). We performed a systematic review in order to evaluate: do these procedures really help to avoid further more aggressive treatments? What are the common harms? What are the rare harms? How many recurrences there are? A total of 21 RCTs were included in this review: 12 on RBL, 4 on IRC and 5 on IS. In RBL bleeding stops in up to 90% and III degree hemorrhoids improves in 78%-83.8%. IV degree prolapse should have a more invasive treatment. The commonest complications are bleeding and pain (8-80%). IRC related improvement is 78%, 51% and 22% for I, II and III degree. Post-operative pain occurs in 15- 100% and post-operative bleeding ranges from 15% to 44%. Recurrence rate is 13% at a three months follow-up. IS brings to the resolution of prolapse in 90%-100% of II degree and allows good results for III degree even if reported only by case series. The post-procedural pain is 36%-49%. Bleeding is a very rare harm. Even if not definitive, these treatments could be an alternative for mild symptomatic patients after a clear explanation of recurrence rates and possible complications.

The non-surgical management for hemorrhoidal disease. A systematic review / Cocorullo, G.; Tutino, R.; Falco, N.; Licari, L.; Orlando, G.; Fontana, T.; Raspanti, C.; Salamone, G.; Scerrino, G.; Gallo, G.; Trompetto, M.; Gulotta, G.. - In: IL GIORNALE DI CHIRURGIA. - ISSN 0391-9005. - 38:1(2017), pp. 5-14. [10.11138/gchir/2017.38.1.005]

The non-surgical management for hemorrhoidal disease. A systematic review

Licari L.;Gallo G.;
2017

Abstract

The non-surgical treatments for hemorrhoids are cost and time-saving techniques usually performed in patients suffering early hemorrhoidal disease. The most used are rubber band ligation (RBL), injection sclerotherapy (IS), and infrared coagulation (IRC). We performed a systematic review in order to evaluate: do these procedures really help to avoid further more aggressive treatments? What are the common harms? What are the rare harms? How many recurrences there are? A total of 21 RCTs were included in this review: 12 on RBL, 4 on IRC and 5 on IS. In RBL bleeding stops in up to 90% and III degree hemorrhoids improves in 78%-83.8%. IV degree prolapse should have a more invasive treatment. The commonest complications are bleeding and pain (8-80%). IRC related improvement is 78%, 51% and 22% for I, II and III degree. Post-operative pain occurs in 15- 100% and post-operative bleeding ranges from 15% to 44%. Recurrence rate is 13% at a three months follow-up. IS brings to the resolution of prolapse in 90%-100% of II degree and allows good results for III degree even if reported only by case series. The post-procedural pain is 36%-49%. Bleeding is a very rare harm. Even if not definitive, these treatments could be an alternative for mild symptomatic patients after a clear explanation of recurrence rates and possible complications.
2017
hemorrhoid complications; hemorrhoid infrared coagulation; hemorrhoid ligation; hemorrhoid sclerotherapy; outpatient treatment; review
01 Pubblicazione su rivista::01g Articolo di rassegna (Review)
The non-surgical management for hemorrhoidal disease. A systematic review / Cocorullo, G.; Tutino, R.; Falco, N.; Licari, L.; Orlando, G.; Fontana, T.; Raspanti, C.; Salamone, G.; Scerrino, G.; Gallo, G.; Trompetto, M.; Gulotta, G.. - In: IL GIORNALE DI CHIRURGIA. - ISSN 0391-9005. - 38:1(2017), pp. 5-14. [10.11138/gchir/2017.38.1.005]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1661276
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