Comparison of rubber band ligation with 3% polidocanol injection sclerotherapy for the treatment of internal haemorrhoids at a Nigerian tertiary hospital

Makanjuola, Ayomide; Balogun, Olanrewaju Solomon; Osinowo, Adedapo Olumide; Adesanya, AA; Rocha, John Taiwo da

doi:10.4103/npmj.npmj_232_20

Cited by 11 publications

(11 citation statements)

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“…The recent studies by Abiodun and Makanjoula analyzed bleeding and prolapse resolution separately. The first study showed a preference for RBL for prolapse resolution and in IS for bleeding resolution, whereas the second showed a comparable efficacy for both techniques ( 26 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Makanjoula et al performed a prospective comparative study on 74 patients with grade I–III HD, comparing IS with 3% polidocanol and RBL at 3-month follow-up. The authors highlight that the two techniques are equally effective for the treatment of patients with grade I–III HD ( 27 ). The data are summarized in Table 1 .…”

Section: Technical Notesmentioning

confidence: 99%

“…In the study by Makanjoula et al, rates of minor complications were similar in both groups (5.7% in RBL vs. 8.1% in IS; p = 0.643). The median pain score was significantly higher in the RBL group compared to the IS group after the first and second sessions ( p < 0.001) ( 27 ). Cirrhotic patients undergoing IS showed higher rates of minor complications and severe anal pain only in the study performed by Awad et al ( 23 ).…”

Section: Technical Notesmentioning

confidence: 99%

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A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses

et al. 2022

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Outpatient treatments are actually the techniques of choice in the management of low-grade hemorrhoidal disease. Among these, rubber band ligation (RBL) and injection sclerotherapy (IS) are the most frequently performed. Both techniques are used, without one having been determined to be superior over the other. We analyzed the studies that compare these two techniques in terms of efficacy and safety in order to offer a proposal for treatment choice. RBL seems to be most efficient in terms of symptom resolution for second-degree hemorrhoidal disease and equal or superior for treatment of third-degree disease. However, IS offers lower rates of severe post-operative pain and minor complications. Since outpatient treatments are offered to patients as painless options that allow a prompt recovery, we propose a stepwise protocol using 3% polidocanol or aluminum potassium sulfate and tannic acid IS as the first treatment option, as it has less complications, followed by RBL in cases of relapse.

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Section: Discussionmentioning

confidence: 99%

Section: Technical Notesmentioning

confidence: 99%

Section: Technical Notesmentioning

confidence: 99%

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A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses

et al. 2022

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“…There was no significant difference in the incidence of complications between the EBL and EIS groups, but the pain of EBL was significantly more than that of EIS. Therefore, both EIS and EBL are recommended as safe and feasible first-line treatments for hemorrhoids [ 19 ]. Compared with EIS, EBL had a higher success rate and required fewer courses of treatment to relieve the symptoms of prolapse and complications and previous research.…”

Section: Injection Sclerotherapymentioning

confidence: 99%

Sclerotherapy in Hemorrhoids

Chen

2022

Indian J Surg

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Injection sclerotherapy for all grades of interhemorrhoids in various situations and co-morbidities has become popular method of treatment. Several types of surgical operations both conventional and stapled hemorrhoidectomy has many and serious described side effects. On the contrary, proctoscopic injection sclerotherapy using some of the modern sclerosants and thin bore needle injections is an office-based ambulatory method of treatment of internal hemorrhoids; it is low in cost, devoid of any major complications besides it is quite successful as reported. Its safety and efficacy has been published in recent years. This manuscript is a result of thorough systemic review using PRISMA guidelines on various sclerosing agents, their merits and demerits, methods of administration, and outcome in internal hemorrhoids.

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“…However, high post-procedural bleeding rates (ranging from 3.5% to-50%), including late bleeding, have been reported [ 1 , 15 , 18 , 20 ]. Sclerotherapy is associated with lower bleeding rates but is more recurrence-prone [ 1 , 15 , 21 – 24 ]. The innovative use of polidocanol as a foam has drawn attention in recent years because of its improved sclerosing capacity, superior efficacy, the need for fewer office-based sessions and less complications, including bleeding and pain [ 15 , 21 – 23 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Polidocanol foam sclerotherapy in the treatment of hemorrhoidal disease in patients with bleeding disorders: a multicenter, prospective, cohort study

et al. 2022

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Background The management of hemorrhoidal disease (HD) in patients with bleeding disorders (BD) is challenging. Polidocanol foam sclerotherapy (PFS) is associated with a low rate of bleeding complications. The aim of this study was to compare the efficacy and safety of PFS in the treatment of HD in patients with and without BD. Methods This prospective, multicenter, cohort study enrolled patients with (group B) and without (group A) BD, with symptomatic internal HD grades I–III over an 18-month period. All patients were treated with PFS. Patients with congenital BD did not undergo prior replacement therapy and those with acquired BD due to antithrombotic drugs, did not discontinue therapy. Efficacy outcomes included therapeutic success and HD recurrence during a 1-year follow-up period. To evaluate safety the complications related to PFS were recorded. Results We included 228 patients (group A: 155, group B: 73; male/female: 114/114; mean age: 59.4 ± 15.9 years). The baseline hemorrhoidal disease bleeding grade ( p < 0.001 ) and Sodergren hemorrhoidal symptom severity score ( p = 0.019 ) were higher for group B. The overall therapeutic success rate was 93.4% with an average number of sessions of 1.51 ± 0.74, significantly higher for group B (1.68 ± 0.86 vs 1.43 ± 0.65, p = 0.013 ). Complications occurred in 11.4% of the patients, with bleeding reported in 4.8%. The majority of complications were mild (96.2%). No significant differences between the two groups were observed for therapeutic success, recurrence, or complication rate. Conclusions Patients with BD may have more symptomatic HD at baseline. Even so, PSF showed similar effectiveness and safety in patients with BD compared to patients without BD. Supplementary Information The online version contains supplementary material available at 10.1007/s10151-022-02600-5.

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Comparison of rubber band ligation with 3% polidocanol injection sclerotherapy for the treatment of internal haemorrhoids at a Nigerian tertiary hospital

Cited by 11 publications

References 1 publication

A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses

A Stepwise Proposal for Low-Grade Hemorrhoidal Disease: Injection Sclerotherapy as a First-Line Treatment and Rubber Band Ligation for Persistent Relapses

Sclerotherapy in Hemorrhoids

Polidocanol foam sclerotherapy in the treatment of hemorrhoidal disease in patients with bleeding disorders: a multicenter, prospective, cohort study

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