Log in

Outcomes of case-matched injection sclerotherapy with a new agent for hemorrhoids in patients treated with or without blood thinners

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

In Japan, a new type of sclerotherapy termed ALTA (aluminum potassium sulfate and tannic acid) injection therapy has recently been introduced. The objectives of this study were to determine whether the presence or absence of antithrombotic treatment (AT) affected the efficacy rate or the occurrence of complications associated with ALTA injection sclerotherapy.

Methods

This study was a case-matched study of 37 patients who underwent ALTA therapy to treat hemorrhoids between 2007 and 2009. Each AT patient was matched for age and degree of hemorrhoids with a control non-AT patient. In each of the subgroups, the therapeutic efficacy of ALTA therapy was evaluated by comparing an assessment completed before therapy with an assessment completed 6 months after therapy.

Results

The efficacy in patients with bleeding did not differ between the two groups (P = 0.074). The efficacy in patients with prolapse was significantly lower in the AT group than in the non-AT group (P = 0.013). The two groups did not differ significantly in the occurrence of complications (P = 0.450).

Conclusions

Among patients with hemorrhoids receiving AT, ALTA injection sclerotherapy is recommended for those in whom it is difficult to discontinue AT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Spain)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Takano M, Iwadare J, Ohba H, et al. Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision. Int J Colorectal Dis. 2006;21:44–51.

    Article  PubMed  CAS  Google Scholar 

  2. Hachiro Y, Kunimoto M, Abe T, et al. Aluminum potassium sulfate and tannic acid (ALTA) injection as the mainstay of treatment for internal hemorrhoids. Surg Today. 2011;41:806–9.

    Article  PubMed  CAS  Google Scholar 

  3. Hachiro Y, Kunimoto M, Abe T, Kitada M, Ebisawa Y. Aluminum potassium sulfate and tannic acid injection in the treatment of total rectal prolapse: early outcomes. Dis Colon Rectum. 2007;50:1996–2000.

    Article  PubMed  Google Scholar 

  4. Liao JK. Secondary prevention of stroke and transient ischemic attack: is more platelet inhibition the answer? Circulation. 2007;115:1615–21.

    Article  PubMed  Google Scholar 

  5. Santos G, Novell JR, Khoury G, Winslet MC, Lewis AA. Long-term results of large-dose, single-session phenol injection sclerotherapy for hemorrhoids. Dis Colon Rectum. 1993;36:958–61.

    Article  PubMed  CAS  Google Scholar 

  6. Zanon E, Martinelli F, Bacci C, Cordioli G, Girolami A. Safety of dental extraction among consecutive patients on oral anticoagulant treatment managed using a specific dental management protocol. Blood Coagul Fibrinolysis. 2003;14:27–30.

    Article  PubMed  CAS  Google Scholar 

  7. Dixon AJ, Dixon MP, Dixon JB. Bleeding complications in skin cancer surgery are associated with warfarin but not aspirin therapy. Br J Surg. 2007;94:1356–60.

    Article  PubMed  CAS  Google Scholar 

  8. Timothy SK, Hicks TC, Opelka FG, Timmcke AE, Beck DE. Colonoscopy in the patient requiring anticoagulation. Dis Colon Rectum. 2001;44:1845–9.

    Article  PubMed  CAS  Google Scholar 

  9. Cataldo P, Ellis CN, Gregorcyk S, et al. Practice parameters for the management of hemorrhoids. Dis Colon Rectum. 2005;48:189–94.

    Article  PubMed  Google Scholar 

  10. Moesgaard F, Nielsen ML, Hansen JB, Knudsen JT. High-fiber diet reduces bleeding and pain in patients with hemorrhoids: a double-blind trial of Vi-Siblin. Dis Colon Rectum. 1982;25:454–6.

    Article  PubMed  CAS  Google Scholar 

  11. Doshi VS, Say JH, Young SH, Doraisamy P. Complications in stroke patients: a study carried out at the Rehabilitation Medicine Service, Changi General Hospital. Singap Med J. 2003;44:643–52.

    CAS  Google Scholar 

  12. Nelson RS, Ewing BM, Ternent C, Shashidharan M, Blatchford GJ, Thorson AG. Risk of late bleeding following hemorrhoidal banding in patients on antithrombotic prophylaxis. Am J Surg. 2008;196:994–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Takuro Shimbo, M.D., Department of Clinical Research and Informatics, National Center for Global Health and Medicine, Tokyo, Japan, for his careful advice regarding the analyses.

Conflict of interest

The authors declare no conflicts of interest. No financial support or affiliations are associated with this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T. Yano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yano, T., Nogaki, T., Asano, M. et al. Outcomes of case-matched injection sclerotherapy with a new agent for hemorrhoids in patients treated with or without blood thinners. Surg Today 43, 854–858 (2013). https://doi.org/10.1007/s00595-012-0365-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-012-0365-8

Keywords

Navigation