Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 18, 2016; 8(20): 844-849
Published online Jul 18, 2016. doi: 10.4254/wjh.v8.i20.844
Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades II and III hemorrhoids: Results from a multicenter study
Hidenori Miyamoto, Takenori Hada, Gentaro Ishiyama, Yoshito Ono, Hideo Watanabe
Hidenori Miyamoto, Department of Digestive and Pediatric Surgery, Institute of Health Bioscience, University of Tokushima Graduate School, Tokushima 770-8503, Japan
Hidenori Miyamoto, Department of Proctologic Surgery, Shiseikai Miyamoto Hospital, Anan, Tokushima 779-1105, Japan
Takenori Hada, Division of Proctologic Surgery, Onaka Clinic Oshiri Center, Hachiouji, Tokyo 192-0083, Japan
Gentaro Ishiyama, Department of Anorectal Surgery, Sapporo Ishiyama Hospital, Sapporo, Hokkaido 064-0915, Japan
Yoshito Ono, Hideo Watanabe, Department of Surgery, Watanabe Hospital, Matsuyama, Ehime 791-0054, Japan
Author contributions: Miyamoto H designed the study; Miyamoto H, Hada T, Ishiyama G, Ono Y and Watanabe H acquired, analyzed and interpreted the data, and drafted the manuscript; Hada T contributed to statistical advice.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Miyamoto Hospital.
Informed consent statement: All study participants or their legal guardian provided informed consent written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hidenori Miyamoto, MD, PhD, Department of Digestive and Pediatric Surgery, Institute of Health Bioscience, University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan. hnna@diamond.nmt.ne.jp
Telephone: +81-88-6337137 Fax: +81-88-6319698
Received: March 16, 2016
Peer-review started: March 18, 2016
First decision: April 18, 2016
Revised: May 29, 2016
Accepted: June 14, 2016
Article in press: June 16, 2016
Published online: July 18, 2016
Processing time: 119 Days and 2.2 Hours
Abstract

AIM: To show that aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has a high success rate for Grade II and III hemorrhoids.

METHODS: This study was based on the clinical data of 604 patients with hemorrhoids who underwent ALTA sclerotherapy between January 2009 and February 2015. The objective of this study was to assess the efficacy of this treatment for Grades II and III hemorrhoids. Preoperative and postoperative symptoms, complications and success rate were all assessed retrospectively. Follow-up consisted of a simple questionnaire, physical examination and an anoscopy. Patients were followed-up at one day, one week, two weeks, one month, one year, two years, three years, four years and five years after the ALTA sclerotherapy.

RESULTS: One hundred and sixty-nine patients were diagnosed with Grade II hemorrhoids and 435 patients were diagnosed with Grade III hemorrhoids. The one year, three year and five year cumulative success rates of ALTA sclerotherapy for Grades II and III hemorrhoids were 95.9% and 93.1%; 89.3% and 83.7%; and 89.3% and 78.2%, respectively. No significant differences were observed in the cumulative success rates after ALTA sclerotherapy between Grades II and III hemorrhoids (P = 0.09). There were forty-seven post-operative complications (low grade fever; anal pain; urinary retention; rectal ulcer; and others). No serious or life-threatening complications occurred and all cases improved through conservative treatment. At univariate analysis there were no predictive factors of failure.

CONCLUSION: ALTA sclerotherapy has had a high success rate for Grade II and III hemorrhoids during five years of post-operative treatment. However, additional studies are needed to evaluate the efficacy of this ALTA sclerotherapy in the management of hemorrhoidal disease.

Keywords: Sclerotherapy; Aluminum potassium sulfate and tannic acid; Goligher grade III; Minimally invasive treatment; Hemorrhoid

Core tip: Since 2000, aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy has been frequently performed in Japan for internal hemorrhoids as a minimally invasive treatment. This study affirms that ALTA sclerotherapy is an effective and safety treatment for Goligher Grades II and III hemorrhoids because of the high cumulative success rate and no serious complications during post-operative treatment.