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ISSN (Print): 1574-8871
ISSN (Online): 1876-1038

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Research Article

Do We Have Another Option to Treat Bleeding Hemorrhoids? The Emborrhoid Technique: Experience in 16 Patients

Author(s): Elisabetta Moggia*, Giuseppina Talamo, Gaetano Gallo, Angelo Bianco, Matteo Barattini, Giancarlo Salsano, Daniele Zefiro, Teseo Stefanini and Stefano Berti

Volume 16, Issue 1, 2021

Published on: 13 March, 2020

Page: [81 - 86] Pages: 6

DOI: 10.2174/1574887115666200313102246

Price: $65

Abstract

Background: Hemorrhoidal disease is very common in western countries and rectal bleeding is the main symptom complained by patients. Nowadays the ultimate goal of treatment is to block the bleeding with minimally-invasive techniques to minimize post-procedural pain.

Objective: The aim of this study is to assess the preliminary results of the emborrhoid technique (embolization of the superior rectal arteries branches) as a new tool for the proctologist to treat severe bleeding hemorrhoids causing anemia. Many categories of patients might benefit from this treatment, such as patients not eligible for conventional surgery, patients not responding to conventional treatment and fit patients with severe bleeding who refused endorectal surgical therapy.

Methods: From May 2017 to November 2018 a total of 16 patients with chronic rectal bleeding due to hemorrhoids underwent super-selective embolization of the superior rectal arteries at the department of General Surgery in La Spezia, S. Andrea Hospital, Italy. Median age was 59 years. 14 patients were males (87.5%).

Results: No post-procedural and short-term complications were observed at maximum follow up (12 months). The reduction of rectal bleeding with improvement of the quality of life was obtained in 14 patients (87.5%).

Conclusion: Our study, although small in number, demonstrates that embolization of superior rectal arteries with coils to treat severe bleeding due to hemorrhoids is safe and effective and does not lead to immediate complications.

Keywords: Embolization, bleeding hemorrhoids, hemorrhoidal disease, superior rectal artery branches, interventional radiology, endovascular coils.

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Graphical Abstract

[1]
Schuurman JP, Go PM, Bleys RL. Anatomical branches of the superior rectal artery in the distal rectum. Colorectal Dis 2009; 11(9): 967-71.
[http://dx.doi.org/10.1111/j.1463-1318.2008.01729.x] [PMID: 19175645]
[2]
Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part II: Lower gastrointestinal diseases. Gastroenterology 2009; 136(3): 741-54.
[http://dx.doi.org/10.1053/j.gastro.2009.01.015] [PMID: 19166855]
[3]
Gallo G, Sacco R, Sammarco G. Epidemiology of hemorroida disease.Hemorrhoids Coloproctology. Cham: Springer 2018; Vol. 2.
[4]
Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology 1990; 98(2): 380-6.
[http://dx.doi.org/10.1016/0016-5085(90)90828-O] [PMID: 2295392]
[5]
Acheson AG, Scholefield JH, Scholefield JH. Management of haemorrhoids. BMJ 2008; 336(7640): 380-3.
[http://dx.doi.org/10.1136/bmj.39465.674745.80] [PMID: 18276714]
[6]
Shafik A, Mostafa H. Study of the arterial pattern of the rectum and its clinical application. Acta Anat (Basel) 1996; 157(1): 80-6.
[http://dx.doi.org/10.1159/000147869] [PMID: 9096745]
[7]
Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol 1995; 90(4): 610-3.
[PMID: 7717320]
[8]
Aigner F, Bodner G, Conrad F, Mbaka G, Kreczy A, Fritsch H. The superior rectal artery and its branching pattern with regard to its clinical influence on ligation techniques for internal hemorrhoids. Am J Surg 2004; 187(1): 102-8.
[http://dx.doi.org/10.1016/j.amjsurg.2002.11.003] [PMID: 14706597]
[9]
Vidal V, Louis G, Bartoli JM, Sielezneff I. Embolization of the hemorrhoidal arteries (the emborrhoid technique): A new concept and challenge for interventional radiology. Diagn Interv Imaging 2014; 95(3): 307-15.
[http://dx.doi.org/10.1016/j.diii.2014.01.016] [PMID: 24589187]
[10]
Vidal V, Sapoval M, Sielezneff Y, et al. Emborrhoid: A new concept for the treatment of hemorrhoids with arterial embolization: The first 14 cases. Cardiovasc Intervent Radiol 2015; 38(1): 72-8.
[http://dx.doi.org/10.1007/s00270-014-1017-8] [PMID: 25366092]
[11]
Moussa N, Sielezneff I, Sapoval M, et al. Embolization of the superior rectal arteries for chronic bleeding due to haemorrhoidal disease. Colorectal Dis 2017; 19(2): 194-9.
[http://dx.doi.org/10.1111/codi.13430] [PMID: 27338153]
[12]
Tincello DG, Owen RK, Slack MC, Abrams KR. Validation of the Patient Global Impression scales for use in detrusor overactivity: Secondary analysis of the RELAX study. BJOG 2013; 120(2): 212-6.
[http://dx.doi.org/10.1111/1471-0528.12069] [PMID: 23189940]
[13]
Burckhardt CS, Anderson KL. The Quality of Life Scale (QOLS): reliability, validity, and utilization. Health Qual Life Outcomes 2003; 1: 60.
[http://dx.doi.org/10.1186/1477-7525-1-60] [PMID: 14613562]
[14]
Giordano P, Nastro P, Davies A, Gravante G. Prospective evaluation of stapled haemorrhoidopexy versus transanal haemorrhoidal dearterialisation for stage II and III haemorrhoids: Three-year outcomes. Tech Coloproctol 2011; 15(1): 67-73.
[http://dx.doi.org/10.1007/s10151-010-0667-z] [PMID: 21318581]
[15]
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: A new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 2004; 240(2): 205-13.
[http://dx.doi.org/10.1097/01.sla.0000133083.54934.ae] [PMID: 15273542]
[16]
Peruzzo Cornetto A, Pasquino M, Aimonetto S, et al. Interventional radiology at a single institution over 9 years: A comprehensive evaluation of procedures and an estimation of collective effective dose. J Vasc Interv Radiol 2012; 23(12): 1665-1675.e2.
[http://dx.doi.org/10.1016/j.jvir.2012.08.027] [PMID: 23177114]
[17]
Tradi F, Louis G, Giorgi R, et al. Embolization of the Superior Rectal Arteries for Hemorrhoidal Disease: Prospective Results in 25 Patients. J Vasc Interv Radiol 2018; 29(6): 884-892.e1. Epub ahead of print
[http://dx.doi.org/10.1016/j.jvir.2018.01.778] [PMID: 29724519]
[18]
Zakharchenko A, Kaitoukov Y, Vinnik Y, et al. Safety and efficacy of superior rectal artery embolization with particles and metallic coils for the treatment of hemorrhoids (Emborrhoid technique). Diagn Interv Imaging 2016; 97(11): 1079-84.
[http://dx.doi.org/10.1016/j.diii.2016.08.002] [PMID: 27597728]
[19]
Tradi F, Mege D, Louis G, Bartoli JM, Sielezneff I, Vidal V. Emborrhoïd : traitement des hémorroïdes par embolisation des artères rectales. Presse Med 2019; 48(4): 454-9.
[http://dx.doi.org/10.1016/j.lpm.2019.04.011] [PMID: 31060764]

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