Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease
Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease
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DOI：
10.1080/08941939.2020.1745964
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发表时间：
2020-04-14
影响因子：
1.9
通讯作者：
Gallo, Gaetano
中科院分区：
文献类型：
--
作者：
Lobascio, Pierluigi;Laforgia, Rita;Gallo, Gaetano
背景：痔疮病（HD）被定义为有症状的肛门垫增大和/或远端移位，是最常见的直肠疾病之一。3%聚多醇泡沫硬化疗法（ST）引起粘膜下组织硬化的炎症反应，导致痔组织悬浮。本研究的目的是评估ST与3%聚多坎醇泡沫治疗有症状的二度和三度HD的短期有效性和安全性。方法：在2017年3月至2018年7月期间，共有66例有症状的二度和三度HD患者接受了单次ST治疗。视觉模拟量表评分用于评估术后疼痛和患者满意度。分别在基线、4周和1年后通过痔疮严重程度评分（HSS）和Vaizey评分调查症状严重程度和肛门失禁。结果：66例患者中男性57例（86.3%），平均年龄52岁（29-75;SD +/- 12）岁。平均手术时间为4.5 （2-6;SD +/- 1.23）分钟。无术中并发症及药物相关副作用发生。单次ST治疗后的总成功率为78.8%（52/66例），两次ST治疗后的总成功率为86%（57/66例）。比较每位患者术前和12个月症状评分得出的平均治疗效果中位数变化为8 （p < 0.001）。所有患者在手术后的第二天都恢复了正常的日常活动。结论：3%聚多元醇泡沫治疗ST是一种安全、经济、可重复的保守治疗方法。
Background: Hemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the hemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods: A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analog scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through the Hemorrhoid Severity Score (HSS) and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results: Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD +/- 12) years. The mean operative time was 4.5 (2-6; SD +/- 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and 12 months symptom scores in each patient, showed a median change of 8 (p < 0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions: ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.