Distal Hemorrhoidectomy With ALTA Injection: A New Method for Hemorrhoid Surgery

Abstract

Aluminum potassium sulfate and tannic acid injection (ALTA) is a useful and less-invasive treatment for internal hemorrhoids. However, it is not a treatment option for external hemorrhoidal diseases, including mixed hemorrhoids. Distal hemorrhoidectomy with ALTA injection involves surgical resection of external piles, followed by injection therapy on internal piles. We report technical details and the short-term results of this procedure in patients with mixed hemorrhoids. Seventy-two patients with mixed hemorrhoids treated between 2010 and 2011 were included. The main outcome measures were the short-term response and complication rates. At 28 days after surgery, the disappearance rate of prolapse was 100%. Three patients (4%) had postoperative complications, all minor in nature. No prolapse recurrence was observed within a median follow-up period of 6 months. Distal hemorrhoidectomy with ALTA injection appears to be a promising treatment option for patients with mixed hemorrhoids.

Is There a Relationship Between Stool Consistency and Pain at First Defecation After Limited Half Hemorrhoidectomy? A Pilot Study

“…This was a prospective cohort study of patients who underwent distal hemorrhoidectomy with aluminum potassium sulfate and tannic acid (DH-ALTA) [ 8 ] for grade III or IV hemorrhoids between March 2019 and July 2019 at the Yano Proctological Clinic (Takamatsu, Japan). The patients were classified into 3 groups according to stool consistency, and the intensity of pain at defecation was compared among the 3 groups.…”

Are graduating residents sufficiently competent? Results of a national gap analysis survey of program directors and graduating residents in Japan

“…For gastroenterological surgeries, such as hemorrhoidectomies and splenectomies, which are thought to be common surgeries by PDs, there was lower self-assessed competency even among the GRs training to be gastroenterological surgeons. With new sclerosing procedures, which requires a special license to perform, hemorrhoidectomies are moving from general hospitals to highly specialized clinics and with specialized surgeons performing the procedures [13,14]. The introduction of minimally invasive surgery has replaced open surgery for splenectomies in the developed world and made it a complex surgery [15].…”

Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids

“…Thus, those who were not satisfied with the result may have been disappointed that ALTA therapy was not effective in eliminating external hemorrhoids or skin tags, as expected. In the future, the combination of excision and ALTA therapy may be indicated for patients with internal hemorrhoids who also have external hemorrhoids, anal polyps, or anal skin tags [8,15].…”