Global treatment of haemorrhoids—A worldwide snapshot audit conducted by the International Society of University Colon and Rectal Surgeons

Issued Date

2024-01-01

Resource Type

Article

ISSN

14628910

eISSN

14631318

DOI

10.1111/codi.17140

Scopus ID

2-s2.0-85201815212

Journal Title

Colorectal Disease

Rights Holder(s)

SCOPUS

Bibliographic Citation

Colorectal Disease (2024)

Suggested Citation

Samalavicius N.E., Gupta R.K., Nunoo-Mensah J., Fortunato R., Lohsiriwat V., Khanal B., Kumar A., Sah B., Cerkauskaite D., Dulskas A., Centeno-Flores M.W., Julie L., Brochado M.C.R.T., Sah N.P., Sattar R.A., Wahhab A., Francisco A., Islam A., Khaled A., Shehab A., Abdulaziz A., Maria A.K., Serdar A., Carlos A., Jaeeta A., Florin A., Michel A., Ağalar H.F., Piyush A., Afshar M.A., Srikant A., Piyush A., Puneet A., Ahmed A.M., Robert A., Akgül Ö.L., Akin M.İ., Cihangir A., Ömer A., Angel A., Justin A., Andrej A., Suelene A., Flavia A., Ali S.M., Ali M.S., Galindo R.A., Shimaa A., Huda A., Bader A., Gulum A., Ediz A., Fjoralba A., Alvarez-Bautista F.E., Oscar A.C., Hugo A., Fabio A., Edgar A., Amaranathan A., Marco A., Guntis A., Andres A., John A., Eleni A., Jose A., Alfredo A., Pietro A., Nicola A., Amedeo A., Dragana A., Giulio A., Can A., Maftin A., Baha A., Arslan N.C., Yüksel A., Dmitri A., Pasquale A., Viktor A., Attaoui M.A., Goran A., Ralph A., Francesco A., Andrea A., Avcıoğlu B.Ü., Abraham A., Erol A., Amanda A., Zohra A., José A., Romarico A., Bag Y.M., Giulia B., Abubakar B., Glen B., Bengi B., Emre B., Balkan S.M., Ruben B., Balta A.Z. Global treatment of haemorrhoids—A worldwide snapshot audit conducted by the International Society of University Colon and Rectal Surgeons. Colorectal Disease (2024). doi:10.1111/codi.17140 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/100657

Title

Global treatment of haemorrhoids—A worldwide snapshot audit conducted by the International Society of University Colon and Rectal Surgeons

Author(s)

Samalavicius N.E.
 Gupta R.K.
 Nunoo-Mensah J.
 Fortunato R.
 Lohsiriwat V.
 Khanal B.
 Kumar A.
 Sah B.
 Cerkauskaite D.
 Dulskas A.
 Centeno-Flores M.W.
 Julie L.
 Brochado M.C.R.T.
 Sah N.P.
 Sattar R.A.
 Wahhab A.
 Francisco A.
 Islam A.
 Khaled A.
 Shehab A.
 Abdulaziz A.
 Maria A.K.
 Serdar A.
 Carlos A.
 Jaeeta A.
 Florin A.
 Michel A.
 Ağalar H.F.
 Piyush A.
 Afshar M.A.
 Srikant A.
 Piyush A.
 Puneet A.
 Ahmed A.M.
 Robert A.
 Akgül Ö.L.
 Akin M.İ.
 Cihangir A.
 Ömer A.
 Angel A.
 Justin A.
 Andrej A.
 Suelene A.
 Flavia A.
 Ali S.M.
 Ali M.S.
 Galindo R.A.
 Shimaa A.
 Huda A.
 Bader A.
 Gulum A.
 Ediz A.
 Fjoralba A.
 Alvarez-Bautista F.E.
 Oscar A.C.
 Hugo A.
 Fabio A.
 Edgar A.
 Amaranathan A.
 Marco A.
 Guntis A.
 Andres A.
 John A.
 Eleni A.
 Jose A.
 Alfredo A.
 Pietro A.
 Nicola A.
 Amedeo A.
 Dragana A.
 Giulio A.
 Can A.
 Maftin A.
 Baha A.
 Arslan N.C.
 Yüksel A.
 Dmitri A.
 Pasquale A.
 Viktor A.
 Attaoui M.A.
 Goran A.
 Ralph A.
 Francesco A.
 Andrea A.
 Avcıoğlu B.Ü.
 Abraham A.
 Erol A.
 Amanda A.
 Zohra A.
 José A.
 Romarico A.
 Bag Y.M.
 Giulia B.
 Abubakar B.
 Glen B.
 Bengi B.
 Emre B.
 Balkan S.M.
 Ruben B.
 Balta A.Z.

Author's Affiliation

SMK Aukštoji mokykla
 Siriraj Hospital
 B.P. Koirala Institute of Health Sciences
 Vilniaus Universitetas
 King's College Hospital NHS Foundation Trust
 Allegheny General Hospital
 Hila
 Cleveland Clinic
 National Cancer Institute

Corresponding Author(s)

Samalavicius N.E.

Other Contributor(s)

Mahidol University

Abstract

Aim: There is no universally accepted treatment consensus for haemorrhoids, and thus, management has been individualized all over the world. This study was conducted to assess a global view of how surgeons manage haemorrhoids. Methods: The research panel of the International Society of University Colon and Rectal Surgeons (ISUCRS) developed a voluntary, anonymous questionnaire evaluating surgeons' experience, volume and treatment approaches to haemorrhoids. The 44 multiple-choice questionnaire was available for one month via the ISUCRS email database and the social media platforms Viber and WhatsApp. Results: The survey was completed by 1005 surgeons from 103 countries; 931 (92.6%) were in active practice, 819 (81.5%) were between 30 and 60 years of age, and 822 (81.8%) were male. Detailed patient history (92.9%), perineal inspection (91.2%), and digital rectal examination (91.1%) were the most common assessment methods. For internal haemorrhoids, 924 (91.9%) of participants graded them I–IV, with the degree of haemorrhoids being the most important factor considered to determine the treatment approach (76.3%). The most common nonprocedural/conservative treatment consisted of increased daily fibre intake (86.9%), increased water intake (82.7%), and normalization of bowel habits/toilet training (74.4%). Conservative treatment was the first-line treatment for symptomatic first (92.5%), second (72.4%) and third (47.3%) degree haemorrhoids; however, surgery was the first-line treatment for symptomatic fourth degree haemorrhoids (77.6%). Rubber band ligation was the second-line treatment in first (50.7%) and second (47.2%) degree haemorrhoids, whereas surgery was the second-line treatment in third (82.9%) and fourth (16.7%) degree symptomatic haemorrhoids. Rubber band ligation was performed in the office by 645(64.2%) of the participants. The most common surgical procedure performed for haemorrhoids was an excisional haemorrhoidectomy for both internal (87.1%) and external (89.7%) haemorrhoids – with 716 (71.2%) of participants removing 1, 2 or 3 sectors as necessary. Conclusion: Although there is no global haemorrhoidal treatment consensus, there are many practice similarities among the different cultures, resources, volume and experience of surgeons around the world. With additional studies, a consensus statement could potentially be developed.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/100657

Collections

Scopus 2024