A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses
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 ove...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2021.782800/full |
| _version_ | 1798034302966956032 |
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| author | Roberta Tutino Roberta Tutino Marco Massani Leonel Jospin Kamdem Mambou Paolina Venturelli Immacolata Della Valle Giuseppina Melfa Matilde Micheli Gaia Russo Gregorio Scerrino Sebastiano Bonventre Gianfranco Cocorullo |
| author_facet | Roberta Tutino Roberta Tutino Marco Massani Leonel Jospin Kamdem Mambou Paolina Venturelli Immacolata Della Valle Giuseppina Melfa Matilde Micheli Gaia Russo Gregorio Scerrino Sebastiano Bonventre Gianfranco Cocorullo |
| author_sort | Roberta Tutino |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-11T20:42:21Z |
| format | Article |
| id | doaj.art-2df3384a9dad4f0db778b4cd571d50c6 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T20:42:21Z |
| publishDate | 2022-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-2df3384a9dad4f0db778b4cd571d50c62022-12-22T04:04:09ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-01-01810.3389/fsurg.2021.782800782800A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent RelapsesRoberta Tutino0Roberta Tutino1Marco Massani2Leonel Jospin Kamdem Mambou3Paolina Venturelli4Immacolata Della Valle5Giuseppina Melfa6Matilde Micheli7Gaia Russo8Gregorio Scerrino9Sebastiano Bonventre10Gianfranco Cocorullo11Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyChirurgia 1, Ospedale Regionale di Treviso, Azienda ULSS 2 Marca Trevigiana, Treviso, ItalyChirurgia 1, Ospedale Regionale di Treviso, Azienda ULSS 2 Marca Trevigiana, Treviso, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyDepartment of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, ItalyOutpatient 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.https://www.frontiersin.org/articles/10.3389/fsurg.2021.782800/fullhemorrhoidshemorrhoid ligationhemorrhoid sclerotherapyreviewoutpatient treatmenthemorrhoid complications |
| spellingShingle | Roberta Tutino Roberta Tutino Marco Massani Leonel Jospin Kamdem Mambou Paolina Venturelli Immacolata Della Valle Giuseppina Melfa Matilde Micheli Gaia Russo Gregorio Scerrino Sebastiano Bonventre Gianfranco Cocorullo A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses Frontiers in Surgery hemorrhoids hemorrhoid ligation hemorrhoid sclerotherapy review outpatient treatment hemorrhoid complications |
| title | A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses |
| title_full | A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses |
| title_fullStr | A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses |
| title_full_unstemmed | A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses |
| title_short | A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses |
| title_sort | stepwise proposal for low grade hemorrhoidal disease injection sclerotherapy as a first line treatment and rubber band ligation for persistent relapses |
| topic | hemorrhoids hemorrhoid ligation hemorrhoid sclerotherapy review outpatient treatment hemorrhoid complications |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2021.782800/full |
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