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Aluminum potassium sulfate and tannic acid sclerotherapy for Goligher Grades Ⅱ and Ⅲ hemorrhoids: Results from a multicenter study

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World Journal of Hepatology 2016年第20期8卷 844-849页

作者： Hidenori Miyamoto takenori hada Gentaro Ishiyama Yoshito Ono Hideo Watanabe Department of Digestive and Pediatric Surgery Institute of Health Bioscience University of Tokushima Graduate School Department of Proctologic Surgery Shiseikai Miyamoto Hospital Division of Proctologic Surgery Onaka Clinic Oshiri Center Department of Anorectal Surgery Sapporo Ishiyama Hospital Department of Surgery Watanabe Hospital

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

关键词： sclerotherapy Aluminum potassium sulfate and tannic acid Goligher grade Ⅲ Minimally invasive treatment Hemorrhoid

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Clipping Method. a Modified Procedure of Transanal Endoscopic Microsurgery （TEM）

Clipping Method. a Modified Procedure of Transanal Endoscopi...

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第六次全国大肠癌会议暨中日韩大肠癌会议

作者： Kazuto Sasaya takenori hada Toshio lino Michiaki Watanabe Masaichi Ogawa Yasushi Kaneko Eiichiro Miura Kenji lkeuchi Masakazu Iwamoto Sadao Anazawa Yoji Yamazaki Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine Department of surgery. Daisan hospital the Jikei university school of medicine

＜正＞Transanal Endoscopic Microsurgery（TEM） has been reported to be a better operating method for resecting a rectal mucosal lesion than any other conventional transanal or transsacral procedure. One of the greatest advantage of TEM is en bloc resection with safety margin even of large sized lesion. Nevertheless. according to our clinical experiences, an enough safety margin could not be secured in more than 30％ of cases in our series, including cases in which local recurrence occurred, requiring additional surgery. To perform en bloc resection completely with a safety margin, we modified TEM by using hemoclips and proved to be useful clinical practice.

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