AI Article Synopsis
- RBL is more effective for resolving symptoms in second-degree hemorrhoids and is at least as good for third-degree ones, while IS has lower rates of severe pain and complications.
- A proposed treatment plan starts with IS using 3% polidocanol or aluminum potassium sulfate and tannic acid for fewer complications, moving to RBL only if needed for relapses.
Article Abstract
Outpatient treatments are actually the techniques of choice in the management of low-grade hemorrhoidal disease. Among these, rubber band ligation (RBL) and injection sclerotherapy (IS) are the most frequently performed. Both techniques are used, without one having been determined to be superior over the other. We analyzed the studies that compare these two techniques in terms of efficacy and safety in order to offer a proposal for treatment choice. RBL seems to be most efficient in terms of symptom resolution for second-degree hemorrhoidal disease and equal or superior for treatment of third-degree disease. However, IS offers lower rates of severe post-operative pain and minor complications. Since outpatient treatments are offered to patients as painless options that allow a prompt recovery, we propose a stepwise protocol using 3% polidocanol or aluminum potassium sulfate and tannic acid IS as the first treatment option, as it has less complications, followed by RBL in cases of relapse.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8784409 | PMC |
| http://dx.doi.org/10.3389/fsurg.2021.782800 | DOI Listing |
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