Cic edizioni internazionali
Il Giornale di Chirurgia

The non-surgical management for hemorrhoidal disease.
A systematic review

Review, 5 - 14
doi: 10.11138/gchir/2017.38.1.005
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Abstract
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The non-surgical treatments for hemorrhoids are cost and time-saving techniques usually performed in patients suffering early hemorrhoidal disease. The most used are rubber band ligation (RBL), injection sclerotherapy (IS), and infrared coagulation (IRC). We
performed a systematic review in order to evaluate: do these procedures really help to avoid further more aggressive treatments? What are the common harms? What are the rare harms? How many recurrences there are? A total of 21 RCTs were included in this review: 12 on RBL, 4 on IRC and 5 on IS. In RBL bleeding stops in up to 90% and III degree hemorrhoids improves in 78%-83.8%. IV degree prolapse should have a more invasive treatment. The commonest complications are bleeding and pain (8-80%). IRC related improvement is 78%, 51% and 22% for I, II and III degree. Post-operative pain occurs in 15-100% and post-operative bleeding ranges from 15% to 44%. Recurrence rate is 13% at a three months follow-up. IS brings to the resolution of prolapse in 90%-100% of II degree and allows good results for III degree even if reported only by case series. The post-procedural pain is 36%-49%. Bleeding is a very rare harm.
Even if not definitive, these treatments could be an alternative for mild symptomatic patients after a clear explanation of recurrence rates and possible complications.

Vol. XXXVIII (No. 1) 2017 January - February

  1. The non-surgical management for hemorrhoidal disease. A systematic review
    Cocorullo G., Tutino R., Falco N., Licari L., Orlando G., Fontana T., Raspanti C., Salamone G., Scerrino G., Gallo G., Trompetto M., Gulotta G.
    doi: 10.11138/gchir/2017.38.1.005
  2. 23-hour observation endocrine neck surgery: lessons learned from a case series of over 1700 patients
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    doi: 10.11138/gchir/2017.38.1.015
  3. Lymph node assessment in colorectal cancer surgery: laparoscopic versus open techniques
    Balducci G., Sederino M.G., Laforgia R., Carbotta G., Minafra M., Delvecchio A., Fedele S., Tromba A., Carbone F., Palasciano N.
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  4. Caecal leiomyoma detected by whole-body MRI in a patient with Hodgkin lymphoma: first case report
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    doi: 10.11138/gchir/2017.38.1.027
  5. Deep sternal wound infections: a severe complication after cardiac surgery
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    doi: 10.11138/gchir/2017.38.1.033
  6. Neoplastic sigmoid-uterine fistula. An exceptional complication of large intestine cancer
    Zanghì G., Leanza V., Vecchio R., D'Agati A., Cordova S., Rinzivillo N.M., Lodato M., Leanza G.
    doi: 10.11138/gchir/2017.38.1.037
  7. Deep SSI after mesh-mediated groin hernia repair: management and outcome in an Emergency Surgery Department
    Salamone G., Licari L., Augello G., Campanella S., Falco N., Tutino R., Cocorullo G., Gullo R., Raspanti C., De Marco P., Porrello C., Profita G., Gulotta G.
    doi: 10.11138/gchir/2017.38.1.041
  8. Agenesis of the internal carotid artery: a family pathology?
    Perla F.M., Carbotta G., Di Nardo D., D'Avanzo M., Colaiacomo M.C., Di Biasi C., Falvo L., Carbotta S., Maturo A., Tartaglia F., Tromba L.
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  9. Cyanoacrylate sealant compared to fibrin glue in staple line reinforcement during laparoscopic sleeve gastrectomy. Pilot prospective observational study
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    doi: 10.11138/gchir/2017.38.1.050
  10. Supergiant fecaloma as manifestation of chronic constipation
    Currò G., Lazzara C., Latteri S., Bartolotta M., Navarra G.
    doi: 10.11138/gchir/2017.38.1.053
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  1. The non-surgical management for hemorrhoidal disease.
    A systematic review

    Cocorullo G., Tutino R., Falco N., Licari L., Orlando G., Fontana T., Raspanti C., Salamone G., Scerrino G., Gallo G., Trompetto M., Gulotta G.
    doi: 10.11138/gchir/2017.38.1.005
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