Department of Surgery, Sant'Eugenio Hospital, Viale dell'Umanesimo 10, 00144, Rome, Italy.
Emergency Surgery Unit, University Hospital of Tor Vergara, viale Oxford 81, 00133, Rome, Italy.
Int J Colorectal Dis. 2021 Jun;36(6):1321-1322. doi: 10.1007/s00384-021-03848-3. Epub 2021 Jan 16.
In Italy, colorectal surgery has been strongly affected with the vast majority (90%) of operations treating benign diseases, with an estimated overall 12-week cancellation rate of 72%. Little is known on how to best manage patients with benign diseases and the consequences this interruption of care will have in post-pandemic times. Proctologic diseases have social, psychological, and healthcare repercussions for their high incidence and great impact on the quality of life.
We decided to treated 10 urgent cases affected from III- and IV-degree hemorrhoids with 3% polidocanol foam in attempt to reduce hemorrhoidal symptoms while waiting for surgery so called "bridge treatment".
During the follow-up no complications were occurred, and all patients had resolution of bleeding and pruritus with a mean VAS of 1 (range, 0-1).
This treatment could reduce the bleeding that is the main symptom from which patients suffer and for which they underwent proctological evaluation and surgery. According to our preliminary experience in the impossibility of accessing the surgery during the COVID-19 pandemic, ST could be considered as the treatment of choice in those patients who are suffering from grade III- and IV-degree hemorrhoids while waiting for surgery.
在意大利，大多数结直肠手术（90%）都用于治疗良性疾病，整体预计有 72%的手术会被取消。对于如何更好地管理患有良性疾病的患者以及在大流行后中断治疗会带来什么后果，我们知之甚少。肛肠疾病的发病率高，对生活质量的影响大，对患者具有社会、心理和医疗方面的影响。
我们决定对 10 例 III 度和 IV 度痔的紧急患者进行 3%聚多卡醇泡沫治疗，以期在等待手术期间减轻痔的症状，即所谓的“桥接治疗”。
在随访期间，未发生任何并发症，所有患者的出血和瘙痒均得到缓解，平均 VAS 评分为 1 分（范围为 0-1）。
这种治疗方法可以减轻患者最主要的症状，即出血，对于因出血而接受肛肠评估和手术的患者来说，这是一种有效的治疗方法。根据我们在 COVID-19 大流行期间无法进行手术的初步经验，对于那些患有 III 度和 IV 度痔的患者，ST 可被视为手术前的首选治疗方法。
