The Emborrhoid Technique for Treatment of Bleeding Hemorrhoids in Patients with High Surgical Risk.

Autor: Campennì P; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., Iezzi R; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy.; Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy., Marra AA; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., Posa A; Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Istituto di Radiologia, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., Parello A; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., Litta F; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., De Simone V; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy., Ratto C; Proctology Unit, Fondazione Policlinico Universitario Agostino Gemelli-IRCCS, 00168 Rome, Italy.; Department of Medicine and Translational Surgery, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2022 Sep 21; Vol. 11 (19). Date of Electronic Publication: 2022 Sep 21.
DOI: 10.3390/jcm11195533
Abstrakt: The Emborrhoid is an innovative non-surgical technique for the treatment of severe hemorrhoidal bleeding. Patient selection and the impact on quality of life have not been fully investigated. This prospective observational study aims to evaluate the clinical outcomes after Emborrhoid in patients with high surgical risk. All patients with high surgical risk and anemia due to hemorrhoids were enrolled. Clinical data and previous blood transfusions were collected. The Hemorrhoidal Disease Symptom Score and Short Health Scala were completed before the procedure and during the follow-up visits at 1, 6 and 12 months. Transfusions and serum hemoglobin level variations were registered. Perioperative complications and the recurrence of bleeding were assessed. Trans-radial/femoral embolization of superior rectal artery, and/or middle rectal artery was performed with Interlock and Detachable Embolization Coils. From September 2020 to February 2022, 21 patients underwent a superselective embolization of all branches of the superior rectal artery. The transradial approach was most frequently performed compared to transfemoral access. After the procedure, no signs of ischemia were identified; three minor complications were observed. The mean follow-up was 18.5 ± 6.0 months. At the last follow-up, the mean increase of hemoglobin for patients was 1.2 ± 1.6 g/dL. Three patients needed transfusions during follow-up for recurrent hemorrhoidal bleeding. The Hemorrhoidal Disease Symptom Score and Short Health Scala decreased from 11.1 ± 4.2 to 4.7 ± 4.6 (p < 0.0001) and from 18.8 ± 4.8 to 10.2 ± 4.9 (p < 0.0001), respectively. Patients who had given up on their daily activities due to anemia have returned to their previous lifestyle. Emborrhoid seems to be a safe and effective option for the treatment of bleeding hemorrhoids in frail patients. The low complication rate and the significant reduction of post-defecation bleeding episodes are related to the improvement of the hemorrhoidal symptoms and patients’ quality of life.
Competing Interests: The authors declare no conflict of interest.
Databáze: MEDLINE
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