Subscribe to RSS
DOI: 10.1055/s-0039-1700251
Flexible Video-Endsocopic Injection Sclerotherapy for Second and Third Degree Internal Hemorrhoids
Publication History
Received: 17 August 2010
Accepted: 17 December 2010
Publication Date:
26 September 2019 (online)
ABSTRACT
Background and objectives: Bleeding from hemorrhoids is the commonest cause of rectal bleeding in adults. Injection sclerotherapy of internal hemorrhoids is one of the non-surgical treatments, and is simple, safe and feasible. Conventionally sclerotherapy is performed with rigid proctoscope which has limitations of maneuverability, narrower field of vision and documentation compared to flexible videoendoscope. Therefore, we assessed the efficacy and safety of video-colonoscopic sclerotherapy for bleeding internal hemorrhides.
Methods: Seventy-nine patients of bleeding internal hemorrhoids were subjected to colonoscopic sclerotherapy using 1.5% polidocanol in retroflexed or forward viewing positions. Success of treatment was defined as cessation of bleeding for six weeks. Patients were observed for complications and were followed up regularly for 3 months.
Results: A total of 79 evaluable patients, 61 had grade II and 18 had grade III hemorrhoids. There was no statistically significant differences in achieving excellent or good results for control of bleeding between patients with grade II and grade III hemorrhoids (100% vs 94,5%; p>0.05). The number of sessions of sclerotherapy required were significantly more in grade II than grade III hemorrhoids (1.1 ± 0.3 vs 1.3 ± 0.7; p = 0.04). No significant complications were noted except for bloating in ten patients (12.6 %) and rectal pain in 6 (7.6%) patients. Median time taken for the procedure was 30 minutes.
Conclusions: Video-endoscopic sclerotherapy is safe, well-tolerated and effective treatment for bleeding internal hemorrhoids.(J Dig Endosc 2011;2(1):1-5)
-
References
- 1 Madoff RD, Fleshman JW. American Gastroenterological Association Technical Review on the diagnosis and treatment of hemorrhoids. Gastroenterology 2004;126:1463-73.
- 2 Steele SR, Madoff RD. Systematic review: the treatment of anal fissure. Alimentary Pharmacology & Therapeutics 2006;24: 247–57.
- 3 Chong PS, Bartolo DCC. Hemorrhoids and Fissure in Ano. Gastroenterol Clin N Am 2008;37: 627–44.
- 4 Sim AJ, Murie JA, Mackenzie I. Three year follow-up study on the treatment of first and second-degree hemorrhoids by sclerosant injection or rubber band ligation. Surg Gynecol Obstet 1983;157:534-6.
- 5 Berkelhammer C, Moosvi SB. Retroflexed endoscopic band ligation of bleeding internal hemorrhoids. Gastrointest Endoscopy 2002;55:532-7.
- 6 MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 1995;38:687–94.
- 7 Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. Am J Gastroenterol 1992;87:1600–6.
- 8 Senapati A, Nicholls RJ. A randomised trial to compare the results of injection sclerotherapy with a bulk laxative alone in the treatment of bleeding haemorrhoids. Int J Colorectal Dis 1988;3:124–6.
- 9 Su MY, Chiu CT, Wu CS, Ho YP, Lien JM, Tung SY, Chen PC. Endoscopic hemorrhoidal ligation of symptomatic internal hemorrhoids. Gastrointest Endosc 2003;58: 871–4.
- 10 Banov L Jr, Knoepp LF Jr, Erdman LH, Alia RT. Management of hemorrhoidal disease. J S C Med Assoc 1985;81:398-401.
- 11 Ponsky JL, Mellinger JD, Simon IB. Endoscopic retrograde hemorrhoid sclerotherapy using 23.4% saline: a preliminary report. Gastrointest Endosc 1991;37:155-8.
- 12 Benin P, D’Amico C. Foam sclerotherapy with Fibrovein (STD) for the treatment of hemorrhoids, using a flexible endoscope. Minerva Chir 2007;62:235-40.
- 13 Chiappone GM, Malpas PM. Endoscopic retrograde hemorrhoid sclerotherapy. Gastroenterol Nurs 1992;15:78-80.
- 14 Johanson JF, Rimm A. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation and injection sclerotherapy. Am J Gastroenterol 1992;87:1600-6.
- 15 Alatise OI, Arigbabu OA, Lawal OO, Adesunkanmi AK, Agbakwuru AE, Ndububa DA, Akinola DO. Endoscopic hemorrhoidal sclerotherapy using 50% dextrose water: a preliminary report. Indian J Gastroenterol 2009;28:31–2.
- 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;60:191-5.
- 17 Takano M, Iwadare J, Ohba H, Takamura H, Masuda Y, Matsuo K, Kanai T et al. Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision. Int J Colorectal Dis 2006;21:44-51.
- 18 Sim AJ, Murie JA, Mackenzie I. Comparison of rubber band ligation and sclerosant injection for first and second degree haemorrhoids-a prospective clinical trial. Acta Chir Scand 1981;147:717-20.