Annals of Coloproctology

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Benign proctology,Postoperative outcome & ERAS,Surgical technique

Early postoperative outcomes of a novel nonexcisional technique using aluminum potassium sulfate and tannic acid sclerotherapy with mucopexy on patients with grade III hemorrhoids: Shunya Takada, Akira Tsunoda, Tomoko Takahashi, Hiroshi Kusanagi; Ann Coloproctol. 2022;38(4):290-296. Published online November 2, 2021; DOI: https://doi.org/10.3393/ac.2020.00920.0131

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1 Web of Science
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Purpose
Aluminum potassium sulfate and tannic acid (ALTA; Zion, Mitsubishi Pharma Corp.) is an effective sclerosing agent for internal hemorrhoids. ALTA therapy with a rectal mucopexy (AM) is a new approach for treating hemorrhoidal prolapse. This study compared the early postoperative outcomes of AM surgery with Doppler-guided transanal hemorrhoidal dearterialization and mucopexy (DM) in patients with third-degree hemorrhoids.
Methods
AM surgery was performed on 32 patients with grade III hemorrhoids and was compared with a cohort of 22 patients who underwent DM surgery in a previous randomized controlled trial.
Results
The pain scores during defecation were significantly lower in the AM patients beginning 4 days after surgery. The total use of analgesics 2 weeks postoperatively was significantly lower in the AM patients than in the DM patients (3.5 tablets [range 1.6–5.5] vs. 7.6 tablets [range 3.3–11.9], P=0.04). The length of operation, blood loss, and incidence of postoperative complications were significantly lower in the AM patients than in the DM patients. During 12 months follow-up, recurrence of prolapse occurred in 1 patient who underwent AM surgery.
Conclusion
AM surgery is effective, with lower complication rates and postoperative analgesic requirements, and is a less invasive treatment for patients with grade III hemorrhoids compared to DM surgery.

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Mid-term outcome of a novel nonexcisional technique using aluminum potassium sulfate and tannic acid sclerotherapy with mucopexy on patients with grade III hemorrhoids
A. Tsunoda, H. Kusanagi
Techniques in Coloproctology.2023; 27(12): 1335. CrossRef

Benign proctology,Biomarker & risk factor

Factors Predicting the Presence of Concomitant Enterocele and Rectocele in Female Patients With External Rectal Prolapse: Akira Tsunoda, Tomoko Takahashi, Kenji Sato, Hiroshi Kusanagi; Ann Coloproctol. 2021;37(4):218-224. Published online January 12, 2021; DOI: https://doi.org/10.3393/ac.2020.07.16

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147 Download
4 Web of Science
5 Citations

Abstract PDF

Purpose
External rectal prolapse (ERP) is frequently associated with other pelvic disorders, such as enterocele, rectocele, and perineal descent. Evacuation proctography makes it possible to visualize the development of such anatomical abnormalities. The aim of this study was to identify the variables that would predict associated abnormalities in patients with ERP.
Methods
Between February 2010 and August 2019, 124 female patients with ERP, who were evaluated using proctography were included in this study. Enterocele was diagnosed when the extension of the loop of the small bowel was located between the vagina and rectum. A significant rectocele was defined as >20 mm in diameter. Multivariate analysis was used to establish which morphological parameters best predicted the presence of enterocele or rectocele.
Results
Sixty-five patients had ERP alone, while 59 patients (47.6%) had additional findings on proctography. The most frequently associated abnormality was enterocele with 48 of the patients (38.7%) having this condition. Rectocele was detected in 17 of the 124 patients (13.7%). The median length of the ERP was 30 mm (range, 7 to 147 mm). The results of the stepwise multiple regression analysis showed that a history of hysterectomy and the length of the ERP were significantly associated with the presence of enterocele. The analysis showed that the longer the prolapse, the higher the incidence of enterocele. A history of hysterectomy was also significantly associated with the presence of rectocele.
Conclusion
Patients with ERP often have associated anatomical abnormalities and should be investigated thoroughly before planning surgical treatment.

Citations

Citations to this article as recorded by

Transverse perineal support improves long-term outcomes in patients undergoing stapled transanal rectal resection for obstructed defecation syndrome: a multicenter observational case-control study
Adolfo Renzi, Luigi Marano, Pasquale Talento, Luigi Brusciano, Angela Pezzolla, Domenico Izzo, Carmine Antropoli, Francesco D’Aniello, Giandomenico Di Sarno, Gianluca Minieri, Grazia Cantore, Gianmattia Terracciano, Domenico Barbato, Ludovico Docimo, Mass
Annals of Coloproctology.2025; 41(4): 330. CrossRef
Small intestine prolapse after vaginal hysterectomy with vaginal dome rupture. A clinical case
Aydar M. Ziganshin, Irina G. Mukhametdinova, Victoria F. Allayarova, Elina A. Shayhieva
Journal of obstetrics and women's diseases.2023; 71(6): 107. CrossRef
Comments on: factors predicting the presence of concomitant enterocele and rectocele in female patients with external rectal prolapse
Ingrid Melo-Amaral, Adrian Teran-Cardoza, Cristopher Varela
Annals of Coloproctology.2022; 38(1): 93. CrossRef
Robot-Assisted Colorectal Surgery
Young Il Kim
The Ewha Medical Journal.2022;[Epub] CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef

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