Efficacy and safety of office-based procedures for hemorrhoidal disease in patients with inflammatory bowel disease.

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Techniques in Coloproctology Pub Date : 2025-05-08 DOI:10.1007/s10151-025-03144-0

T Carvalho, T Leal, B Arroja, P Mesquita, I Malta, T Gago, A R Gonçalves, R Coelho, S B Ponte, P Salgueiro, F Castro-Poças, A C Bravo, C Gouveia, A M Oliveira, M Francisco, R Gonçalves, A C Caetano

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引用次数: 0

Abstract

Background: Hemorrhoidal disease (HD) affects 2-20% of patients with inflammatory bowel disease (IBD) but treatment recommendations are scarce due to fear of higher morbidity in these patients. Currently, there is almost no data regarding nonsurgical treatment for HD in patients with IBD. This study aimed to evaluate the safety and efficacy of office-based procedures for HD in patients with IBD.

Methods: A Portuguese multicenter retrospective study of patients with IBD undergoing office-based treatment for HD between July 2013 and December 2021 was performed. Data regarding the patients' IBD (type, disease location, medication, endoscopic remission) and HD (clinical success, recurrence, complications) were analyzed.

Results: A total of 129 patients were included, 90 with ulcerative colitis and 37 with Crohn's disease. Only 55% of patients presented endoscopic remission and 18% were under biologics. Additionally, 77 patients underwent rubber band ligation (RBL), 44 underwent polidocanol injection, and 8 had both treatments, for a total of 304 procedures. The treatment of HD was effective in 88% of patients, of which 16% relapsed (mean follow-up time of 55.3 ± 34.5 months). Complications were described in 17 (5.6%) procedures, 2 (0.66%) requiring invasive treatment. There were no cases of suppuration, stenosis, or anal incontinence. Success, relapse, and complications were not associated with IBD features. Clinical success and recurrence were similar between RBL and polidocanol foam sclerotherapy (PFS). RBL had more complications than PFS (15.6% versus 2.6%).

Conclusions: This study is the first to focus exclusively on office-based procedures for hemorrhoidal disease in patients with IBD, demonstrating similar efficacy to the general population and a low complication rate.

查看原文本刊更多论文

炎症性肠病患者痔疮疾病的办公室手术的有效性和安全性。

背景：痔疮病（HD）影响2-20%的炎症性肠病（IBD）患者，但由于担心这些患者的发病率较高，治疗建议很少。目前，几乎没有关于IBD患者HD的非手术治疗的数据。本研究旨在评估基于办公室的程序治疗IBD患者HD的安全性和有效性。方法：对2013年7月至2021年12月期间接受HD办公室治疗的IBD患者进行了一项葡萄牙多中心回顾性研究。分析患者的IBD（类型、疾病部位、用药、内镜下缓解）和HD（临床成功、复发、并发症）数据。结果：共纳入129例患者，其中溃疡性结肠炎90例，克罗恩病37例。只有55%的患者出现内镜缓解，18%的患者接受了生物制剂治疗。此外，77例患者接受了橡皮筋结扎（RBL）， 44例接受了聚多卡因注射，8例接受了两种治疗，总共304例手术。88%的患者治疗有效，其中16%的患者复发（平均随访时间55.3±34.5个月）。17例（5.6%）出现并发症，2例（0.66%）需要侵入性治疗。没有化脓、狭窄或肛门失禁的病例。成功、复发和并发症与IBD特征无关。RBL与聚多醇泡沫硬化治疗（PFS）的临床成功率和复发率相似。RBL的并发症多于PFS（15.6%比2.6%）。结论：这项研究是第一个专门关注IBD患者痔疮疾病的办公室手术，显示出与普通人群相似的疗效和低并发症发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Techniques in Coloproctology GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.30

自引率

9.10%

发文量

176

审稿时长

1 months

期刊介绍： Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.