Transanal eco-Doppler evaluation after hemorrhoidal artery embolization  

作　　者：Roberta Tutino Tommaso Stecca Fabrizio Farneti Marco Massani Giulio Aniello Santoro 

机构地区：[1]Dipartimento Chirurgia Generale e Specialistica,AOU Cittàdella Salute e della Scienza di Torino,Torino 10126,Italy [2]Division of General Surgery 1,Treviso Regional Hospital,AULSS 2 Marca Trevigiana,Treviso 31100,Italy [3]Division of Radiology,Treviso Regional Hospital,AULSS 2 Marca Trevigiana,Treviso 31100,Italy [4]Tertiary Referral Pelvic Floor Center,Division of General Surgery 2,AULSS 2 Marca Trevigiana,Treviso 31100,Italy

出　　处：《World Journal of Gastroenterology》2024年第17期2332-2342,共11页世界胃肠病学杂志（英文版）

基　　金：This study is registered at clinicaltrials.gov.The registration identification number is NCT05627999.

摘　　要：BACKGROUND Hemorrhoidal artery embolization(Emborrhoid)is a novel method for the treatment of severe hemorrhoidal bleeding.Despite having a technical success rate of 93%-100%,the clinical success ranges between 63%and 94%,with a rebleeding rate of 13.6%.AIM To evaluate the effectiveness of this procedure in reducing hemorrhoidal flow and hemorrhoidal bleeding.METHODS This prospective observational pilot study was conducted at Division of General Surgery 1 and Tertiary Referral Pelvic Floor Center,Treviso Regional Hospital,Italy.In a 2 months period(February-March 2022),consecutive patients with hemorrhoidal bleeding scores(HBSs)≥4,Goligher scores of II or III,failure of non-operative management,and a candidate for Emborrhoid were included.Endoanal ultrasound with eco-Doppler was performed preoperatively and 1 month after the procedure.The primary endpoint was to quantify the changes in arterial hemorrhoidal flow after treatment.The secondary endpoint was to evaluate the correlation between the flow changes and the HBS.RESULTS Eleven patients underwent Emborrhoid.The overall pretreatment mean systolic peak(MSP)was 14.66 cm/s.The highest MSP values were found in the anterior left lateral(17.82 cm/s at 1 o’clock and 15.88 cm/s at 3 o’clock)and in the posterior right lateral(14.62 cm/s at 7 o’clock and 16.71 cm/s at 9 o’clock)quadrants of the anal canal.After treatment,the overall MSP values were significantly reduced(P=0.008)although the correlation between MSP and HBS changes was weak(P=0.570).A statistical difference was found between distal embolization compared with proximal embolization(P=0.047).However,the coil landing zone was not related to symptoms improvement(P=1.000).A significant difference in MSP changes was also reported between patients with type 1 and type 2 superior rectal artery(SRA)anatomy(P=0.040).No relationship between hemorrhoidal grades(P=1.000),SRA anatomy(P=1.000)and treatment outcomes was found.CONCLUSION The preliminary findings of this pilot study confirm that Emborrhoid was ef

关 键 词：Hemorrhoidal artery embolization Hemorrhoidal embolization Hemorrhoidal vascularization Transanal eco-Doppler Transanal ultrasound 

分 类 号：R735.7[医药卫生—肿瘤]