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
{"title":"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。","authors":"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","doi":"10.1007/s10151-025-03144-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"111"},"PeriodicalIF":2.9000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062045/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of office-based procedures for hemorrhoidal disease in patients with inflammatory bowel disease.\",\"authors\":\"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\",\"doi\":\"10.1007/s10151-025-03144-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"111\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062045/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-025-03144-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-025-03144-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Efficacy and safety of office-based procedures for hemorrhoidal disease in patients with inflammatory bowel disease.
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.
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.
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