Executive Summary - The Association of Colon &amp; Rectal Surgeons of India (ACRSI) Practice Guidelines for the Management of Haemorrhoids—2016

Agarwal, Nisheeth; Singh, Kumkum; Sheikh, Parvez; Mittal, Kushal; Mathai, Varughese; Kumar, Ashok

doi:10.1007/s12262-016-1578-7

Cited by 36 publications

(38 citation statements)

References 30 publications

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“…[ 1 , 9 , 10 ] Among these modalities, hemorrhoid banding is typically the most effective option, according to the American Society of Colon and Rectal Surgeons (ASCRS) latest clinical practice guidelines for the management of hemorrhoids [ 11 ] and the guidelines for hemorrhoids by the Association of Colon and Rectal Surgeons of India. [ 12 ] Surgical treatment such as hemorrhoidectomy, external hemorrhoid thrombectomy, and stapler hemorrhoidectomy is aimed at those patients who have failed outpatient treatment and have mixed or grade IV internal hemorrhoids. [ 13 , 14 ]…”

Section: Introductionmentioning

confidence: 99%

Progress in endoscopic treatment of hemorrhoids

Guo

Yang

et al. 2020

Journal of Translational Internal Medicine

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Hemorrhoids are one of the most common diseases of the anorectal region. Previously, treatment for hemorrhoids included conservative treatment, outpatient treatment, and surgical treatment. The development of flexible reversible endoscopes has provided precise controllability and imaging, enabling further improvement and development of various endoscopic techniques to treat hemorrhoids. This article discusses several of these endoscopic techniques: rubber band ligation, sclerotherapy, and electrocoagulation. The development, efficacy, and advantages of these treatments are summarized and evaluated. It is expected that going forward, endoscopic technology will be further applied in clinical practice and may become the first-line method for the treatment of hemorrhoids.

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Section: Introductionmentioning

confidence: 99%

Progress in endoscopic treatment of hemorrhoids

Guo

Yang

et al. 2020

Journal of Translational Internal Medicine

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“…Guidelines are based on some common elements that form the foundations: (1) the acquired knowledge regarding the enteropathogenesis and modalities of clinical onset; (2) the classification of the disease that most closely aligns to the various stages of development of the disease; and (3) the treatment, broken down by techniques and level of disease development. The two main reasons for criticizing this approach, that are found in all guidelines produced by national or international scientific societies still available in the literature (ASCRS)[16] such as American College of Gastroenterologists[17], American Gastroenterological Association[18], Japan Society of Coloproctology[19], Italian Society of Colo-rectal Surgery (ISCRS)[20], French Society of Colo-Proctology[21] include: (1) all are based on the Goligher classification, except those of the Association of Colon and Rectal Surgeons of India[22] which adds a further characterization to the grading, given by the number and position of the piles; and (2) the final choice of treatment is left to the surgeon's preference and, as such remains the subject of controversies from both the nosological classification and the therapeutic choices. This substantial conclusion undermines the main objective that remains of a greater homogeneity in the clinical behavior of professionals.…”

Section: Presentmentioning

confidence: 99%

Classification and guidelines of hemorrhoidal disease: Present and future

Rubbini

Ascanelli

2019

WJGS

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Classification and guidelines of hemorrhoidal disease are based on the subdivision in Grades of prolapse followed by any aspect related to both the treatment and its technique. When taking the proposals for classification and guidelines issued by prolific scientific societies into consideration, it is evident that strong contradictions and interpretative limits emerge in finding the best treatment to be adopted. After a critical examination of these limitations, a methodological proposal is shared to achieve a new classification, which plays a part in forming a new guideline for hemorrhoidal disease, identifying its evolution, dynamism of the prolapse, symptomatology, enteropathogenesis and gender characteristics.

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“…There is a range of surgical interventions available including rubber band ligation (RBL), haemorrhoid artery ligation (HAL), stapled haemorrhoidopexy and excisional haemorrhoidectomy, some of which have been assessed in randomised trials [1]. Although there have been attempts to amalgamate these trials and produce guidance regarding optimal treatment pathways, all are subject to interpretation and on occasion guidelines differ substantially [2–4]. One of the major challenges in the comparison of these different studies is the lack of standardised outcomes.…”

Section: Introductionmentioning

confidence: 99%

A validated severity score for haemorrhoids as an essential prerequisite for future haemorrhoid trials

et al. 2019

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Background There is a lack of standardised outcomes for haemorrhoidal disease making comparison between trials difficult. A need for a very well validated severity score is essential to facilitate meta-analysis of comparative studies, enabling evidence-based clinical practice. Methods The Hubble trial provides a large cohort of patients with haemorrhoidal disease randomised to rubber band ligation (RBL) or haemorrhoidal artery ligation. The haemorrhoid severity score (HSS) was collected on each patient at baseline, 6 weeks and 1 year after intervention. This allows for the responsiveness of the HSS instrument to be examined and compared with a more specific instrument, the Vaizey incontinence score (also collected). Responsiveness was tested using four methods (effect size, standardised response means (SRM), significance of change, and responsiveness statistic). Results The four tests of responsiveness demonstrated that the HSS was more responsive to changes in the patient’s health status following both of the interventions compared to the Vaizey questionnaire. For example, between baseline and 6 weeks, the RBL intervention effect size scores and SRM calculations indicated a non-significant small amount of change (0.20 and 0.16 respectively). However, using the HSS, the effect size and SRM demonstrated a large magnitude of change (1.12 and 1.01, respectively) which was significant. Similar results were observed at 1 year. Significance of change scores and the index of responsiveness were also higher for the HSS questionnaire than the Vaizey across both treatment modalities. Conclusions The HSS is a highly responsive tool for the detection of changes in haemorrhoid symptoms. It should form an essential patient-reported outcome tool for future studies on haemorrhoidal disease.

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Executive Summary - The Association of Colon & Rectal Surgeons of India (ACRSI) Practice Guidelines for the Management of Haemorrhoids—2016

Cited by 36 publications

References 30 publications

Progress in endoscopic treatment of hemorrhoids

Progress in endoscopic treatment of hemorrhoids

Classification and guidelines of hemorrhoidal disease: Present and future

A validated severity score for haemorrhoids as an essential prerequisite for future haemorrhoid trials

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