Irvine3 and Nicolaides Labs, Department of Circulation Sciences, Spoltore, Pescara, Italy -
San Valentino Vascular Screening Center, Pescara, Italy -
Minerva Surg. 2024 Jun;79(3):309-314. doi: 10.23736/S2724-5691.23.10241-3.
Hemorrhoids are a common problem associated with symptoms, like swelling, local thrombosis and generally with a decreased quality of life, often in otherwise healthy subjects. Hemorrhoids can be classified by grades (I to IV) according to their severity. In this registry study subjects treated with excisional hemorrhoidectomy (EH) for the first time, were included. After surgery, edema tends to complicate surgical areas causing relevant symptoms. Most hemorrhoids symptoms are related to alterations in bowel habits. Increase in diet fibers to avoid constipation, exercise, and limiting straining reduce recurrence after surgery.
The aim of the registry study was to evaluate the effects of Pycnogenol (Horphag Research, Geneva, Switzerland) on relieving postoperative symptoms following hemorrhoidectomy. Pycnogenol 150 mg/day was used between one month before surgery up to one month after surgery. The main postoperative symptoms were scored.
Thirty-eight subjects completed the 60-day supplement registry study. Eighteen subjects were supplemented with Pycnogenol in addition to the standard management (SM) and 20 subjects only received SM and were considered as controls. The two groups were comparable for age, sex and main symptoms distribution and for their clinical characteristics at inclusion. No other disease was present. The scores for pain, discomfort, and constipation were significantly lower with the supplement compared to controls (P<0.05) 10 and 30 days after surgery. In addition, the quality-of-life score was higher with Pycnogenol (P<0.05) while bleeding (minimal, not clinically evaluable) and a possible residual anal stenosis (requiring a longer period of observation) were barely observed. A satisfactory return to activity was observed 30 days after surgery in the 18 subjects using Pycnogenol, and in only 15 out of 20 patients (75%) in the control group (P<0.05). All Pycnogenol subjects were able to drive and perform daily tasks in comparison with 14 out of 20 subjects in the control group. The proportion of patients that took pain medication from day 10 to 30 post-surgery was significantly lower in the Pycnogenol group than in controls (P<0.05).
In this post-surgical pilot, registry study, Pycnogenol was effective in preventing and controlling postoperative symptoms after hemorrhoidectomy. To confirm the results, more cases are needed, including different surgical methods and clinical conditions. Mucosal and cutaneous edema and perianal swelling - generally seen after surgery - seem to be clearly reduced with Pycnogenol and the supplement intake was associated with a more regular and pain-controlled convalescence and healing.
痔疮是一种常见的疾病，会导致肿胀、局部血栓形成等症状，通常会降低生活质量，但患者通常健康状况良好。痔疮可根据严重程度分为四级（I 至 IV 级）。本注册研究纳入了首次接受痔切除术（EH）治疗的患者。手术后，水肿往往会使手术区域复杂化，导致相关症状。大多数痔疮症状与排便习惯的改变有关。增加饮食中的纤维以避免便秘、运动和限制用力，可以减少手术后的复发。
该注册研究的目的是评估碧萝芷（Horphag Research，瑞士日内瓦）对痔切除术后缓解术后症状的效果。在手术前一个月至手术后一个月期间，每天使用碧萝芷 150 毫克。主要的术后症状被评分。
38 名受试者完成了 60 天的补充剂注册研究。18 名受试者在接受标准治疗（SM）的同时补充了碧萝芷，而 20 名受试者仅接受 SM 治疗作为对照。两组在年龄、性别和主要症状分布以及纳入时的临床特征方面相似。没有其他疾病。与对照组相比，补充剂组的疼痛、不适和便秘评分在手术后 10 天和 30 天时显著降低（P<0.05）。此外，使用碧萝芷的生活质量评分更高（P<0.05），而出血（轻微，无法临床评估）和可能残留的肛门狭窄（需要更长时间的观察）则很少见。18 名使用碧萝芷的受试者在手术后 30 天恢复活动，而对照组 20 名患者中仅 15 名（75%）（P<0.05）。与对照组相比，所有使用碧萝芷的受试者均能够在手术后 10 天至 30 天内驾驶和进行日常活动，而对照组只有 14 名（20 名中的 70%）（P<0.05）。与对照组相比，使用碧萝芷的患者在手术后 10 天至 30 天期间服用止痛药的比例显著降低（P<0.05）。
在本术后试点注册研究中，碧萝芷在预防和控制痔切除术后症状方面是有效的。为了确认结果，还需要更多的病例，包括不同的手术方法和临床情况。手术后通常会出现的黏膜和皮肤水肿以及肛周肿胀似乎明显减少，并且补充剂的摄入与更规律和疼痛控制的康复和愈合有关。
