OBJECTIVE: This study was designed to evaluate anal endosonographic findings in patients with internal haemorrhoids and to test whether endosonographic parameters can serve as prognostic factors for treatment outcome and recurrence. PATIENTS AND METHODS: One hundred and twenty-nine patients (72 males, 57 females, mean age 48 years (range 19-82 years)) were treated for grade 1 to grade 3 internal haemorrhoids with either rubber band ligation (n = 62) or infrared photocoagulation (n = 67). Evaluation before and 1 month after the last treatment consisted of a symptom questionnaire, digital examination, proctoscopy and anal endosonography. The thickness of the submucosa (SMT) and internal (IST) and external anal sphincters (EST) was measured in four quadrants and averaged. Comparisons were made with 40 age- and sex-matched healthy controls. Follow up was 19.2 ± 7.8 months (mean ± s.d.). Multivariate analysis was performed to identify endosonographic factors for treatment outcome and recurrence. RESULTS: Eighty-six patients had grade 1, 34 grade 2 and nine grade 3 haemorrhoids. At endosonography, most but not all haemorrhoids were recognized as anterior thickening of the submucosal layer with a partial hypoechoic appearance. Compared with healthy controls SMT (2.6 ± 0.8 mm vs 2.3 ± 0.5 mm, P < 0.03), IST (1.7 ± 0.5 mm vs 1.5 ± 0.5 mm, P < 0.03) and EST (8.7 ± 1.6 mm vs 7.7 ± 1.4 mm, P < 0.001) were increased. Submucosal thickness correlated with the degree of haemorrhoids (r = 0.19, P = 0.04). No difference in endosonographic appearance of anal morphology was found after treatment. With multivariate analysis no endosonographic factors could be identified which could predict treatment outcome or symptom recurrence. CONCLUSION: Haemorrhoids are associated with endosono- graphic thickening of submucosal tissue, internal and external anal sphincter. Therefore, both sphincters as well as changes in the submucosa might be of pathophysiological importance. Endosonographic changes cannot predict treatment outcome or symptom recurrence.
OBJECTIVE: This study was designed to evaluate anal endosonographic findings in patients with internal haemorrhoids and to test whether endosonographic parameters can serve as prognostic factors for treatment outcome and recurrence. PATIENTS AND METHODS: One hundred and twenty-nine patients (72 males, 57 females, mean age 48 years (range 19-82 years)) were treated for grade 1 to grade 3 internal haemorrhoids with either rubber band ligation (n = 62) or infrared photocoagulation (n = 67). Evaluation before and 1 month after the last treatment consisted of a symptom questionnaire, digital examination, proctoscopy and anal endosonography. The thickness of the submucosa (SMT) and internal (IST) and external anal sphincters (EST) was measured in four quadrants and averaged. Comparisons were made with 40 age- and sex-matched healthy controls. Follow up was 19.2 ± 7.8 months (mean ± s.d.). Multivariate analysis was performed to identify endosonographic factors for treatment outcome and recurrence. RESULTS: Eighty-six patients had grade 1, 34 grade 2 and nine grade 3 haemorrhoids. At endosonography, most but not all haemorrhoids were recognized as anterior thickening of the submucosal layer with a partial hypoechoic appearance. Compared with healthy controls SMT (2.6 ± 0.8 mm vs 2.3 ± 0.5 mm, P < 0.03), IST (1.7 ± 0.5 mm vs 1.5 ± 0.5 mm, P < 0.03) and EST (8.7 ± 1.6 mm vs 7.7 ± 1.4 mm, P < 0.001) were increased. Submucosal thickness correlated with the degree of haemorrhoids (r = 0.19, P = 0.04). No difference in endosonographic appearance of anal morphology was found after treatment. With multivariate analysis no endosonographic factors could be identified which could predict treatment outcome or symptom recurrence. CONCLUSION: Haemorrhoids are associated with endosono- graphic thickening of submucosal tissue, internal and external anal sphincter. Therefore, both sphincters as well as changes in the submucosa might be of pathophysiological importance. Endosonographic changes cannot predict treatment outcome or symptom recurrence.
Authors: Antonio Tarasconi; Gennaro Perrone; Justin Davies; Raul Coimbra; Ernest Moore; Francesco Azzaroli; Hariscine Abongwa; Belinda De Simone; Gaetano Gallo; Giorgio Rossi; Fikri Abu-Zidan; Vanni Agnoletti; Gianluigi de'Angelis; Nicola de'Angelis; Luca Ansaloni; Gian Luca Baiocchi; Paolo Carcoforo; Marco Ceresoli; Alain Chichom-Mefire; Salomone Di Saverio; Federica Gaiani; Mario Giuffrida; Andreas Hecker; Kenji Inaba; Michael Kelly; Andrew Kirkpatrick; Yoram Kluger; Ari Leppäniemi; Andrey Litvin; Carlos Ordoñez; Vittoria Pattonieri; Andrew Peitzman; Manos Pikoulis; Boris Sakakushev; Massimo Sartelli; Vishal Shelat; Edward Tan; Mario Testini; George Velmahos; Imtiaz Wani; Dieter Weber; Walter Biffl; Federico Coccolini; Fausto Catena Journal: World J Emerg Surg Date: 2021-09-16 Impact factor: 5.469
Authors: M Trompetto; G Clerico; G F Cocorullo; P Giordano; F Marino; J Martellucci; G Milito; M Mistrangelo; C Ratto Journal: Tech Coloproctol Date: 2015-09-24 Impact factor: 3.781
Authors: Adilijiang Aimaiti; Ma Mu Ti Jiang A Ba Bai Ke Re; Irshat Ibrahim; Hui Chen; Maimaitituerxun Tuerdi Journal: World J Gastroenterol Date: 2017-05-28 Impact factor: 5.742