Outpatient treatment of isolated strangulated haemorrhoids with single dose injection sclerotherapy and oral Daflon
Deen, K.I.
European Journal of Surgery 162(5): 403-405
1996
ISSN/ISBN: 1102-4151 PMID: 8781922 Document Number: 467763
To find out whether short-term high-dose preoperative radiotherapy can reduce local recurrence rate without increasing postoperative mortality in patients with resectable rectal cancer. Randomised trial. Nationwide Swedish multicentre trial. From March 1987 to February 1990, 1168 patients were randomised. In each group, 454 patients had curative surgery. Patients were allocated to preoperative irradiation (25 Gy in five fractions in one week) followed by operation within a week, or to surgery alone. Postoperative morbidity and mortality, and local recurrence rate. After a minimum follow-up of two years, 9% (51/553) of the patients in the irradiated group who had had the tumour resected had developed a local recurrence, compared with 24% (131/557) in the surgery alone group (p < 0.001). In patients who underwent curative operations, the local recurrence rates were 7% (33/454) and 20% (93/454), respectively (p < 0.001). The corresponding figures for all patients with Dukes' stage tumours were: A 3% (6/181) and 9% (14/154) (p = 0.04); Dukes' stage B 7% (14/195) and 18% (31/173), (p < 0.01) and Dukes' stage C 18% (31/177) and 37% (86/ 230), (p < 0.001), respectively. Preoperative irradiation with a short-term high-dose regimen reduces the local recurrence rate by roughly 65% after a minimum follow-up of two years. The influence on survival will be analysed after a minimum of five years followup. To assess the efficacy of single, large dose injection sclerotherapy together with oral Daflon 500 mg in the management of isolated strangulated haemorrhoids. Prospective non randomised study. Private hospital, Sri Lanka. 15 patients (9 men and 6 women, median age 28 years, range 19-54) with isolated strangulated haemorrhoids. Resolution of symptoms at 12 weeks, residual haemorrhoids, and side effects of Daflon. 14 patients were evaluated at 12 weeks, and symptoms had resolved completely in 13. In all of these patients, the prolapsed haemorrhoid was restored within the anal canal. The remaining patient developed circumferential prolapsed haemorrhoids which were treated by surgical excision. No side effects of Daflon were reported. Single, large dose injection sclerotherapy combined with Daflon 500 mg was beneficial in the short term in patients with isolated strangulated haemorrhoids.