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硫酸铝钾和鞣酸内镜硬化疗法作为内痔非手术治疗方法的有效性

Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids.

作者信息

Tomiki Yuichi, Aoki Jun, Motegi Shunsuke, Takahashi Rina, Hagiwara Toshiaki, Okazawa Yu, Mizukoshi Kosuke, Kawai Masaya, Munakata Shinya, Ishiyama Shun, Sugimoto Kiichi, Sakamoto Kazuhiro

机构信息

Department of Coloproctological Surgery, Juntendo University, Faculty of Medicine, Tokyo, Japan.

出版信息

Clin Endosc. 2019 Nov;52(6):581-587. doi: 10.5946/ce.2019.017. Epub 2019 Jul 24.

Abstract

BACKGROUND/AIMS: Sclerotherapy with aluminum potassium sulfate and tannic acid (ALTA) has a potent effect on internal hemorrhoids. In this retrospective study, we compared the effects of endoscopic ALTA therapy and standard ALTA therapy.

METHODS

We investigated patients who underwent treatment for internal hemorrhoids at our institution between 2014 and 2016. They were divided into a standard ALTA group (n=33, treated using proctoscopy) and an endoscopic ALTA group (n=48). We compared the clinical findings between the 2 groups.

RESULTS

There were no intergroup differences in background factors. The mean ALTA dose was 21.9±7.2 mL and 17.8±3.4 mL in the standard and endoscopic ALTA groups, respectively (p<0.01). Adverse events occurred in 4 patients (12.1%) from the standard ALTA group and 6 patients (12.5%) from the endoscopic ALTA group. In both groups, the patients reported good satisfaction with the therapeutic effect at 1 month after the procedure. Hemorrhoids recurred in 2 patients (6.3%) from the standard ALTA group and 4 patients (8.3%) from the endoscopic ALTA group.

CONCLUSION

Endoscopic ALTA sclerotherapy is equivalent to standard ALTA therapy in terms of efficacy, adverse events, and recurrence. Therefore, it is a useful non-surgical option for patients with internal hemorrhoids who prefer a less invasive treatment.

摘要

背景/目的:硫酸铝钾和鞣酸硬化疗法(ALTA)对内痔有显著疗效。在这项回顾性研究中,我们比较了内镜下ALTA治疗与标准ALTA治疗的效果。

方法

我们调查了2014年至2016年间在我院接受内痔治疗的患者。他们被分为标准ALTA组(n = 33,采用直肠镜检查进行治疗)和内镜ALTA组(n = 48)。我们比较了两组之间的临床结果。

结果

两组患者的背景因素无差异。标准ALTA组和内镜ALTA组的平均ALTA剂量分别为21.9±7.2 mL和17.8±3.4 mL(p<0.01)。标准ALTA组有4例患者(12.1%)出现不良事件,内镜ALTA组有6例患者(12.5%)出现不良事件。两组患者在术后1个月均对治疗效果表示满意。标准ALTA组有2例患者(6.3%)内痔复发,内镜ALTA组有4例患者(8.3%)内痔复发。

结论

内镜下ALTA硬化疗法在疗效、不良事件和复发方面与标准ALTA疗法相当。因此,对于倾向于选择侵入性较小治疗的内痔患者来说,它是一种有用的非手术选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fdb4/6900292/56db632194dc/ce-2019-017f1.jpg

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