title: ALTA injection sclerosing therapy:non-excisional treatment of internal hemorrhoids.
abstract: OBJECTIVE
  Aluminum potassium sulfate and tannic acid (ALTA) is a new sclerosing therapy for internal hemorrhoids. This injection therapy is a four-step direct injection sclerosing procedure intended to shrink and harden internal hemorrhoids to eliminate hemorrhoidal prolapse and bleeding. The aim of this study was to assess the short term efficacy of this treatment.
  
  
  METHODS
  The procedure was conducted using a four-step injection process under perianal local anesthesia. The entry point for the four-step injection of ALTA is the submucosa of the superior pole, the submucosa in the central part, the mucous lamina propria in the central part and the submucosa at the inferior pole of hemorrhoid.
  
  
  RESULTS
  From January 2009 to March 2010, we performed the ALTA sclerosing therapy on 28 patients (14 men and 14 women; mean age, 64.6 years), including 5 second-degree, 16 third-degree and 7 fourth-degree hemorrhoids. There were 6 postoperative complications (2 cases of low grade fever, 2 anal pains, 1 necrosis at injection site and 1 perianal dermatitis). All symptoms of prolapse or bleeding disappeared after 29 postoperative days. There were 3 recurrent cases (10.7%).
  
  
  CONCLUSIONS
  ALTA sclerosing therapy is a useful and less invasive treatment for internal hemorrhoids.
authors.affiliation: Department of Surgery, Shiseikai Miyamoto Hospital, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Michihito
authors.initials: M
authors.lastname: Asanoma
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyamoto
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000534:Alum Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006484:Hemorrhoids / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D007267:Injections; D007564:Japan; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D015911:Sclerotherapy / Q000009:adverse effects; D012720:Severity of Illness Index; D013634:Tannins / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000534:Alum Compounds; D012597:Sclerosing Solutions; D013634:Tannins; C041524:aluminum sulfate