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

Gaspare Gulotta, Gianfranco Cocorullo, Roberta Tutino, Giuseppe Salamone, Leo Licari, Gallo, Trompetto, Trompetto, Trompetto, Cristina Raspanti, Giuseppina Orlando, Nicolo' Falco, Tommaso Fontana

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16 Citations (Scopus)

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.
Original languageEnglish
Pages (from-to)5-14
Number of pages10
JournalIL GIORNALE DI CHIRURGIA
Volume38
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Surgery

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    Gulotta, G., Cocorullo, G., Tutino, R., Salamone, G., Licari, L., Gallo, Trompetto, Trompetto, Trompetto, Raspanti, C., Orlando, G., Falco, N., & Fontana, T. (2017). The non-surgical management for hemorrhoidal disease. A systematic review. IL GIORNALE DI CHIRURGIA, 38, 5-14.