Garg Pankaj, Tulina Inna, Ren Dong-Lin, Bhattacharya Kaushik, Yagnik Vipul D, Mahak Garg
Department of Colorectal Surgery, Garg Fistula Research Institute, Panchkula 134113, Haryana, India.
Department of Oncologic Colorectal Surgery, Sechenov First Moscow State Medical University, Moscow 119991, Russia.
World J Gastrointest Surg. 2025 Jul 27;17(7):107099. doi: 10.4240/wjgs.v17.i7.107099.
Hemorrhoids are one of the most common anorectal disorders. Early hemorrhoids are treated conservatively, but advanced hemorrhoids are usually treated with surgery. However, in the last decade, we have worked extensively in the field of conservative management of hemorrhoids. From our experience, we could manage a large proportion of advanced hemorrhoids without surgery by a treatment concept (TONEFACT) with a high satisfaction rate. Evidence for the TONEFACT approach primarily comes from observational studies and a prospective, non-randomized study of 85 patients. This has been shown to improve defecation time and reduce prolapse symptoms in early-stage hemorrhoids, leading to fewer surgical interventions. Although promising, these observations lack validation from more extensive randomized controlled trials to draw firm conclusions. In this opinion review, without using much data, we will discuss our viewpoint based on our experience as specified by the journal guidelines.
痔疮是最常见的肛肠疾病之一。早期痔疮采用保守治疗，但晚期痔疮通常采用手术治疗。然而，在过去十年中，我们在痔疮保守治疗领域开展了广泛的工作。根据我们的经验，我们可以通过一种治疗理念（TONEFACT），在不进行手术的情况下处理大部分晚期痔疮，且满意度很高。TONEFACT方法的证据主要来自观察性研究以及一项对85名患者进行的前瞻性、非随机研究。研究表明，这一方法可改善早期痔疮患者的排便时间并减轻脱垂症状，从而减少手术干预。尽管前景乐观，但这些观察结果缺乏更广泛的随机对照试验的验证，难以得出确凿结论。在这篇观点综述中，我们将根据期刊指南的要求，在不使用大量数据的情况下，基于我们的经验讨论我们的观点。
