Lobascio Pierluigi, Laforgia Rita, Novelli Eugenio, Perrone Fabrizio, Di Salvo Maria, Pezzolla Angela, Trompetto Mario, Gallo Gaetano
Unit of Laparoscopic Surgery, Department of Emergency and Organ Transplantation, University Medical School "A. Moro" of Bari, Bari, Italy.
Department of Biostatistics, S. Gaudenzio Clinic, Novara, Italy.
J Invest Surg. 2021 Oct;34(10):1059-1065. doi: 10.1080/08941939.2020.1745964. Epub 2020 Apr 15.
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.
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.
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 ( < 0.001). All patients resumed their normal daily activities the day after the procedures.
ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.
痔病（HD）被定义为肛垫的症状性增大和/或向远端移位，是最常见的直肠疾病之一。用3%聚多卡醇泡沫进行硬化治疗（ST）会引发炎症反应，导致黏膜下组织硬化，进而使痔组织悬吊。本研究的目的是评估用3%聚多卡醇泡沫进行ST治疗有症状的二度和三度HD的短期有效性和安全性。
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。采用视觉模拟评分量表评估术后疼痛和患者满意度。分别在基线、4周和1年后，通过痔严重程度评分（HSS）和韦齐评分调查症状严重程度和肛门节制情况。
66例患者中57例为男性（86.3%），平均年龄为52岁（29 - 75岁；标准差±12）。平均手术时间为4.5分钟（2 - 6分钟；标准差±1.23）。未发生术中并发症和与药物相关的副作用。单次ST治疗后总体成功率为78.8%（52/66例患者），两次ST治疗后为86%（57/66例患者）。比较每位患者术前和12个月的症状评分得出的平均治疗效果显示，中位数变化为8（<0.001）。所有患者在治疗后第二天就恢复了正常日常活动。
用3%聚多卡醇泡沫进行ST是一种安全、经济有效且可重复的保守治疗方法。
