Hemorrhoidal Disease Symptom Score and Short Health ScaleHD: New Tools to Evaluate Symptoms and Health-Related Quality of Life in Hemorrhoidal Disease

Rørvik, Håvard D; Styr, Karl; Ilum, Lars; McKinstry, Grant L; Dragesund, Tove; Campos, André H; Brandstrup, Birgitte; Olaison, Gunnar

doi:10.1097/dcr.0000000000001234

Cited by 75 publications

(72 citation statements)

References 28 publications

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“…The operation took 15 min (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) in the LHP group, 29 min (20-38) in the EH group, and 16 min (15-20) in the MP group (Fig. 2), p < 0.001.…”

Section: Resultsmentioning

confidence: 99%

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Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy

Poškus

Danys

Makūnaitė

et al. 2020

Int J Colorectal Dis

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Purpose To compare the results of laser hemorrhoidoplasty (LHP), excisional hemorrhoidectomy (EH), and sutured mucopexy (MP). Methods A randomized, parallel-group, double-blinded, single-center prospective study. Patients Symptomatic 2nd-or 3rd-degree hemorrhoids patients. Interventions Computer randomization sequence, patient blinding, operating surgeon blinding, and surgeon-evaluator blinding. LHP was performed using a 1470 nm diode laser. Up to 250 J of energy delivered per 1 hemorrhoid. The procedure was performed circumferentially. MP ligations were placed in the area of visible hemorrhoidal tissue. Standard EH was performed up to the level of the hemorrhoidal pedicle. Follow-up at 1 and 6 weeks and 1 year. Outcome measures Recurrence of symptoms requiring treatment, intensity, and duration of pain after the operation, patients' quality of life, fecal incontinence, and patients' evaluation of treatment. Results A total of 121 patients. Groups were even preoperatively. LHP took 15 min (SD 5.6), MP took 16 min (SD 5.58), and EH took 29 min (SD 10.3). Recurrence requiring treatment rate was 0% after EH, 10% after LHP, and 22% after MP, p = 0.004. LHP and MP were less painful than EH, p < 0.001. Patients after LHP returned to regular activity after 15 days, after MP after 22 days, and after EH after 30 days, p < 0.001. SF-36 scores were better after EH. Symptoms of fecal incontinence improved in all the groups. Patients evaluate LHP better than EH and MP. Limitations Single-center study. Conclusions Laser hemorrhoidoplasty is a safe, minimally invasive option for hemorrhoids, more effective than MP and less effective than EH. Patients evaluate this technique better than the other two.

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“…The operation took 15 min (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) in the LHP group, 29 min (20-38) in the EH group, and 16 min (15-20) in the MP group (Fig. 2), p < 0.001.…”

Section: Resultsmentioning

confidence: 99%

“…Measuring outcomes in trials for the hemorrhoidal disease is difficult, and validated symptom scores-Sodergren score [13] and Hemorrhoidal Disease Symptom Score and Short Health ScaleHD [14]-were developed to help in this regard. Unfortunately, our study was planned before their publication.…”

Section: Discussionmentioning

confidence: 99%

Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy

Poškus

Danys

Makūnaitė

et al. 2020

Int J Colorectal Dis

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“…Finally, scores also assessed patients' quality of life, such as the Hemorrhoidal Disease Symptom Score, a new version of the HSS score [19] or the HEMO-FISS-Qol score [20].…”

Section: Discussionmentioning

confidence: 99%

Proposal for a New Score: Hemorrhoidal Bleeding Score

Fathallah

Beaussier

Châtellier³

et al. 2021

Ann Coloproctol

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We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS). Methods: All consecutive patients who had consulted between May 1, 2016, and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in two stages. A first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort. Results: One hundred consecutive patients were studied (57 men, mean age 49.70 years). A positive association between HBS and surgery indication was found (p<0.001). A cutoff value of the score of 5 ( 5 vs. > 5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25% respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (OR: 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (p<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 men, mean age 53.14 years) were enrolled with an excellent agreement between two proctologists (kappa= 0.983). Conclusion: HBS is sensitive, specific and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients, and does so in a more efficient way than the Goligher's prolapse score. It also allows to quantify the extent of change in hemorrhoidal bleeding after treatment.

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“…Clinical evaluation using only the Goligher scale could cause confusion regarding true symptomatic recurrence or symptom persistence. A more solid definition of failure or recurrence together with a validated score of symptoms is indispensable in evaluating treatment [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Rubber band ligation versus haemorrhoidectomy for the treatment of grade II–III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials

Dekker

Han-Geurts²,

Rørvik

et al. 2021

Tech Coloproctol

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Background The aim of this study was to review clinical outcome of haemorrhoidectomy and rubber band ligation in grade II–III haemorrhoids. Methods A systematic review was conducted. Medline, Embase, Cochrane Library, Clinicaltrials.gov, and the WHO International Trial Registry Platform were searched, from inception until May 2018, to identify randomised clinical trials comparing rubber band ligation with haemorrhoidectomy for grade II–III haemorrhoids. The primary outcome was control of symptoms. Secondary outcomes included postoperative pain, postoperative complications, anal continence, patient satisfaction, quality of life and healthcare costs were assessed. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results Three hundred and twenty-four studies were identified. Eight trials met the inclusion criteria. All trials were of moderate methodological quality. Outcome measures were diverse and not clearly defined. Control of symptoms was better following haemorrhoidectomy. Patients had less pain after rubber band ligation. There were more complications (bleeding, urinary retention, anal incontinence/stenosis) in the haemorrhoidectomy group. Patient satisfaction was equal in both groups. There were no data on quality of life and healthcare costs except that in one study patients resumed work more early after rubber band ligation. Conclusions Haemorrhoidectomy seems to provide better symptom control but at the cost of more pain and complications. However, due to the poor quality of the studies analysed/it is not possible to determine which of the two procedures provides the best treatment for grade II–III haemorrhoids. Further studies focusing on clearly defined outcome measurements taking patients perspective and economic impact into consideration are required.

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Hemorrhoidal Disease Symptom Score and Short Health ScaleHD: New Tools to Evaluate Symptoms and Health-Related Quality of Life in Hemorrhoidal Disease

Cited by 75 publications

References 28 publications

Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy

Results of the double-blind randomized controlled trial comparing laser hemorrhoidoplasty with sutured mucopexy and excisional hemorrhoidectomy

Proposal for a New Score: Hemorrhoidal Bleeding Score

Rubber band ligation versus haemorrhoidectomy for the treatment of grade II–III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials

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