Evaluation of sclerotherapy with a new sclerosing agent and stapled hemorrhoidopexy for prolapsing internal hemorrhoids: retrospective comparison with hemorrhoidectomy.
BACKGROUND
We retrospectively compared the results of sclerotherapy with a new sclerosing agent (aluminum potassium sulphate/tannic acid) and hemorrhoidopexy using an improved type of circular stapler with hemorrhoidectomy.


METHODS
Between January 2006 and September 2008, we performed hemorrhoidectomy in 416 patients, sclerotherapy in 784 patients and hemorrhoidopexy in 118 patients with prolapsing internal hemorrhoids.


RESULTS
The median volume of the agent injected into a hemorrhoid was 7 ml (interquartile range = 4). The operation duration was significantly shorter (p < 0.01) in sclerotherapy, 13 min (interquartile range = 7), than in hemorrhoidectomy, 43 min (interquartile range = 15), and hemorrhoidopexy, 31 min (interquartile range = 16). Postoperative pain, needing pain killer injection, occurred in 59 patients (14%) in hemorrhoidectomy, 14 patients (1.8%) in sclerotherapy and 1 patient (0.8%) in hemorrhoidopexy (p < 0.01). The disappearance rates of prolapse were 100% (416/416 patients) in hemorrhoidectomy, 96% (753/784 patients) in sclerotherapy and 98.3% (116/118 patients) in hemorrhoidopexy.


CONCLUSIONS
Hemorrhoidectomy, widely applied for hemorrhoids, needs hospitalization, being accompanied by pain. Sclerotherapy could be performed on outpatient bases without any severe pain or complication. Hemorrhoidopexy is a useful alternative treatment with less pain. Less invasive treatments would be useful when performed paying attention to avoid complications.
Department of Surgery and Proctology, Osaka North Japan Post Hospital, Osaka, Japan.
Yukihiko
Y
Tokunaga
Hirokazu
H
Sasaki
Tohru
T
Saito
D000534:Alum Compounds / Q000627:therapeutic use*; D000553:Ambulatory Care; D005260:Female; D006484:Hemorrhoids / Q000601:surgery / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain; D011391:Prolapse; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D013528:Surgical Staplers; D017792:Surgical Stapling; D013634:Tannins / Q000627:therapeutic use*; D016896:Treatment Outcome
D000534:Alum Compounds; D012597:Sclerosing Solutions; D013634:Tannins; C041524:aluminum sulfate