Treatment of thrombosed external hemorrhoids in Russia: an online survey

Garmanova, Tatiana; Bredikhin, Mikhail; Казаченко, Е. А.; Alekberzade, Aftandil; Tulina, Inna; Tsarkov, Petr

doi:10.1007/s10151-020-02287-6

Cited by 3 publications

(1 citation statement)

References 5 publications

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“…Traditionally, the most important discriminant in the choice between medical or surgical treatment is symptoms duration when reaching medical attention. Medical approach is reserved to patients experiencing symptoms beyond 48–72 h from onset ( 3 , 11 , 12 , 18 ). However, there is no evidence in literature that conservative management is best used in cases of early onset of symptoms.…”

Section: Conservative Management and Outcomesmentioning

confidence: 99%

Management and Treatment of External Hemorrhoidal Thrombosis

et al. 2022

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BackgroundExternal hemorrhoidal thrombosis (EHT) is a common complication of hemorrhoidal disease. This condition causes extreme pain, likely resulting from internal anal sphincter hypertonicity, which traps the hemorrhoids below the dentate line thus leading to congestion and swelling. The choice of treatment remains controversial and both conservative and surgical options have been proposed in the last decades.MethodsThis mini-review focuses on the most relevant studies found in literature evaluating conservative and surgical management of EHT. Special conditions such as pregnancy and EHT in elderly patients have been considered.ResultsTraditionally, symptoms duration represents the discriminant in the choice between medical and surgical treatment. Several Coloproctological Societies considered conservative treatment as the first-line approach to EHT and a variety of options have been proposed: wait and see, mixture of flavonoids, mix of lidocaine and nifedipine, botulinum toxin injection and topical application of 0.2% glyceryl trinitrate. Meanwhile, different surgical treatments are recommended when EHT fails to respond to conservative management or when symptoms onset falls within the last 48–72 h: drainage with radial incision, conventional excision, excision under local anesthesia and stapled technique.ConclusionThe management and treatment of EHT is still controversial since no specific guidelines have been published. Both medical and surgical treatment have been proven effective but randomized clinical trials and structured consensus-based guidelines are warranted.

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Section: Conservative Management and Outcomesmentioning

confidence: 99%

Management and Treatment of External Hemorrhoidal Thrombosis

et al. 2022

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Diagnosis and treatment of external hemorrhoids on an outpatient basis

Lomonosov,

Golubev,

Kukanova

et al. 2023

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There are many variants of acute external hemorrhoids (AEH), with varying degrees of its development. The purpose of the study is to study the features of diagnosis and treatment of outpatient patients with AEH in the form of ovoid (AEH–FO). Material and methods. A solid sample, a retrospective sequential study of the data of 97 outpatient patients with AEH–FO. AEH–FO of the first degree (AEH–FO 1) was detected in 57,7% of patients, the node was more often elastic, blue in color, AEH–FO of the second degree (AEH–FO 2) in 42,3% of patients, wound necrosis on the node, the discharge of blood from it. In 32,7% of patients treated on average after 4 days, the average pain on the visual pain scale (VPS) was 6 points. Conservative treatment was carried out in all patients with AEH–FO with the appointment of MOFF (90% diosmin and 10% hesparin flavides. When bleeding from the node, tranexam, psyllium, lactulose, macrogol were prescribed for constipation. Analgesia was performed depending on the intensity of the pain. Only 3,1% of patients were operated on before 2018. Conclusions. The treatment of patients with AEH–FO was eﬀective. In the average treatment period of 14 days, all patients recovered and were able to work.

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Tactics of management of patients with single-node thrombosis of external hemorrhoids

Lomonosov,

Kazakov

et al. 2024

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Uninodular thrombosis of external hemorrhoidal nodes (UTHN) was identified in 81.4% of all forms of thrombosis.Objective. To develop treatment algorithms for patients with UTHN.Material and methods. An analysis of data from 362 outpatient patients with UTHN showed that 81.5% sought help from a proctologist more than 3 days after the onset of thrombosis. In 81.3% of cases, anal pain was absent or mild/moderate in nature. First-degree UTHN (UTHN-1) was found in 91.7% of patients, while second-degree UTHN (UTHN-2) was present in 8.3%. In 305 (84.3%) patients, UTHN was visualized on unchanged anoderm. Constipation was noted in 14.4% of patients. The characteristics of inflammation in patients with UTHN-2 included: 1 — necrosis size up to 5 mm; 2 — slight discharge of pus or blood. Results. Conservative treatment is the primary method for managing patients with UTHN. The use of a conservative treatment algorithm allowed for the recovery of 340 (93.9%) patients within a timeframe of 7 to 19 days. Twenty-two (6.1%) patients with UTHN-1 and UTHN-2 underwent surgery after inflammation subsided. In 45 (9.7%) patients, despite refusing surgery, recovery also occurred. Limitations on performing surgeries in outpatient settings include: 1 — the success rate of conservative treatment; 2 — lack of facilities for performing surgeries in outpatient clinics; 3 — frequent refusals by patients for surgery. The period of disability during the postoperative period averaged 12 ± 1 days.Conclusion. Treatment algorithms for patients with UTHN allow for a balanced use of conservative or surgical treatment methods.

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Treatment of thrombosed external hemorrhoids in Russia: an online survey

Cited by 3 publications

References 5 publications

Management and Treatment of External Hemorrhoidal Thrombosis

Management and Treatment of External Hemorrhoidal Thrombosis

Diagnosis and treatment of external hemorrhoids on an outpatient basis

Tactics of management of patients with single-node thrombosis of external hemorrhoids

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