2005, Number 3
<< Back Next >>
Rev Gastroenterol Mex 2005; 70 (3)
Non-surgical alternative management of hemorrhoidal disease
Charúa GL, Chirino PAE, Navarrete CT, Osorio HRM, Avendaño EO
Language: Spanish
References: 16
Page: 284-290
PDF size: 180.11 Kb.
ABSTRACT
Clinical manifestations of hemorrhoidal disease depend on its location (internal or external) and the presence or not of complications.
Purpose: To describe the results of the three most common alternatives for non-surgical procedures treating internal hemorrhoids: rubber band ligation, esclerotherapy and infrared photocoagulation.
Materials and methods: A retrospective, longitudinal and descriptive study from January 1998 to December 2002 was carried out, including variables like age, gender, clinical manifestations and date of initiation, type of non-surgical alternative treatment, complications, management and stage of the illness.
Results: In 9,103 charts reviewed this study included 2,701 patients with hemorrhoidal disease, with an annual incidence of 540.20 patients; 1,388 (51.39%) were male and 1,313 (48.62%) were female; ages between 17 and 78 years, 44.10 as a mean age. Rubber band ligation was used in 516 patients (67.45 %), esclerotherapy in 177 (23.13 %) and infrared photocoagulation in 72 cases (9.41 %).
Conclusions: Rubber band ligation is mainly indicated for internal hemorrhoids II degree, the esclerotherapy is indicated in the suppression of acute hemorrhage, but in the long term, this method has the poorest results. Infrared photocoagulation has its best results in internal hemorrhoids I degree because it causes less pain and complications and patients accept it better.
REFERENCES
Goligher J. Cirugía de ano, recto y colon. 2a. Ed. Barcelona, España: Editorial Masson; 1998, p. 92-142.
Avendaño EO. Proctología. México, D.F.: Editorial Impresiones Modernas: 1968, p. 44-63.
Corman ML. Hemorrhoids. Colon and rectal surgery. 4th Ed. Philadelphia: Lippincott-Raven; 1998, p. 147-205.
Charúa GL. Enfermedad hemorroidaria. En: Murguía DD (ed.). Gastroenterología y hepatología práctica. Volumen 15. México, D.F.: Intersistemas Editores; 1999, p. 153-7.
Barron J. Office ligation treatment of hemorrhoids. Dis Colon Rectum 1963; 6: 109.
Wai-lun L, Kin-Wah Ch. Triple rubber band ligation for hemorrhoids. Dis Colon Rectum 1999; 42: 363-6.
Neiger A. Hemorrhoids in everyday practice. Proctology 1979; 2: 22.
Charúa GL, Avendaño EO, Hernández CF. La fotocoagulación por rayos infrarrojos en el tratamiento de la enfermedad hemorroidaria. Rev Gastroenterol Méx 1998; 63: 131-4.
Dennison A, Whiston BM, Rooney S. A randomized comparison of infrared photocoagulation with bipolar diathermy for the out-patient treatment of haemorrhoids. Dis Colon Rectum 1990; 33: 32-5.
Goligher JC. Cryosurgery for haemorrhoids. Dis Colon Rectum 1976; 19: 223.
John FJ, Alfred R. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared coagulation, rubber band ligation, and injection sclerotherapy. Am J Gastroenterol 1992; 87(11): 1601-6.
Eugene PS. Nonoperative management of hemorrhoids. Dis Colon Rectum 1999; 42(8): 989-93.
Detrano SJ. Role of cryosurgery in management of anorectal disease. Dis Colon Rectum 1975; 18: 284.
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 1990; 98: 380.
Nicholls RJ. Hemorrhoids. Surgery of the colon and rectum. 1th Ed. London: British Library; 1997, p. 209-31.
Goldberg SM. Fundamentos de cirugía anorrectal. México, D.F.: Editorial Limusa: 1986; 103-21.