Annals of Coloproctology

Original Articles

Benign proctology

Proposal for a New Score: Hemorrhoidal Bleeding Score: Nadia Fathallah, Hélène Beaussier, Gilles Chatellier, Jean Meyer, Marc Sapoval, Nadia Moussa, Vincent de Parades; Ann Coloproctol. 2021;37(5):311-317. Published online September 18, 2020; DOI: https://doi.org/10.3393/ac.2020.08.19

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10 Citations

Purpose
We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
Methods
All consecutive patients who had consulted between May 1, 2016 and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in 2 stages. The first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
Results
One hundred consecutive patients were studied (57 males; mean age, 49.70 years). A positive association between HBS and surgery indication was found (P<0.001). A cut-off value of the score of 5 (≤5 vs. >5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25%, respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (odds ratio, 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (P<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 males; mean age, 53.14 years) were enrolled with an excellent agreement between 2 proctologists (kappa=0.983).
Conclusion
HBS is sensitive, specific, and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients and does so in a more efficient way than the Goligher prolapse score. It also allows quantifying the extent of change in hemorrhoidal bleeding after treatment.

Citations

Citations to this article as recorded by

Hemorrhoidal disease: Epidemiological study and analysis of predictive factors for surgical management
Nadia Fathallah, Amine Alam, Anne L. Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal of Visceral Surgery.2024; 161(3): 161. CrossRef
Pathologie hémorroïdaire : étude épidémiologique et analyse des facteurs de risque de chirurgie
Nadia Fathallah, Amine Alam, Anne-Laure Rentien, Giorgio La Greca, Joshua Co, Elise Pommaret, Amélie Barré, Stéphane Kegne, Hélène Beaussier, Lucas Spindler, Vincent de Parades
Journal de Chirurgie Viscérale.2024; 161(3): 177. CrossRef
Imaging for Hemorrhoidal Disease: Navigating Rectal Artery Embolization from Planning to Follow-up
Jonathan Lindquist, James Hart, Katherine Marchak, Eduardo Bent Robinson, Premal Trivedi
Seminars in Interventional Radiology.2024; 41(03): 263. CrossRef
The efficacy of Aescin combined with MPFF for early control of bleeding from acute hemorrhoids, A randomized controlled trial
Suwan Sanmee, Witcha Vipudhamorn, Pawit Sutharat, Ekkarin Supatrakul
Asian Journal of Surgery.2024;[Epub] CrossRef
Russian multicenter observational HDQ study on the validation of the questionnaire for hemorrhoidal disease
Yu. A. Shelygin, Yu. M. Stoyko, Ivan V. Kostarev, E. A. Zagriadskiǐ, A. M. Bogomazov, E. B. Golovko, Yu. V. Khomitskaya, B. B. Kvasnikov, O. Zh. Linnik
Koloproktologia.2024; 23(4): 101. CrossRef
Emborrhoid technique performed on a patient with portal hypertension and chronic hemorrhoidal bleeding as a salvage therapy
Filipa Alves e Sousa, Pedro Marinho Lopes, Inês Bolais Mónica, Ana Catarina Carvalho, Pedro Sousa
CVIR Endovascular.2022;[Epub] CrossRef
Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Vincent Vidal, Farouk Tradi
Seminars in Interventional Radiology.2022; 39(02): 194. CrossRef
Rectal Artery Embolization for Hemorrhoidal Disease: Anatomy, Evaluation, and Treatment Techniques
Julien Panneau, Diane Mege, Mathieu Di Biseglie, Julie Duclos, Paul Habert, Axel Bartoli, Vincent Vidal, Farouk Tradi
RadioGraphics.2022; 42(6): 1829. CrossRef
Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
Hemorrhoid embolization: A review of current evidences
Reza Talaie, Pooya Torkian, Arash Dooghaie Moghadam, Farouk Tradi, Vincent Vidal, Marc Sapoval, Jafar Golzarian
Diagnostic and Interventional Imaging.2021;[Epub] CrossRef

Benign proctology

Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study: Julie Assaraf, Elsa Lambrescak, Jérémie H Lefèvre, Vincent de Parades, Josée Bourguignon, Isabelle Etienney, Milad Taouk, Patrick Atienza, Jean-David Zeitoun; Ann Coloproctol. 2021;37(2):90-93. Published online January 31, 2020; DOI: https://doi.org/10.3393/ac.2019.06.18

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3 Web of Science
2 Citations

Abstract PDF

Purpose
Anal fistula is a common condition in proctology, usually requiring surgical treatment. Few risk factors have been clearly identified based on solid evidence. Our research objective was to determine whether history of anal surgery was a risk factor for subsequent anal fistula.
Methods
We conducted a case-control study from January 1, 2012 through December 31, 2013 in our tertiary center, comprising 280 cases that underwent surgery for anal fistula and 123 control patients seeking a consultation for upper gastrointestinal symptoms. Patients with inflammatory bowel disease were excluded. For both cases and controls, the following variables were recorded: sex, any prior anal surgery, diabetes mellitus, infection with human immunodeficiency virus, and smoking status. For each variable, confidence interval and odds ratio (OR) were calculated.
Results
In univariate analysis, male sex (73.2% vs. 31.7%, P < 0.0001), active smoking (38.1% vs. 22%, P = 0.0015), and prior anal surgery (16.0% vs. 4.1%, P = 0.0008) were associated with higher risk of anal fistula. In multivariate analysis, only male sex (OR, 5.5; 95% confidence interval [CI], 5.42 to 9.10; P < 0.0001) and previous anal surgery (OR, 4.48; 95% CI, 1.79 to 13.7; P = 0.0008) remained independently associated with anal fistula occurrence.
Conclusion
The epidemiology of anal fistula is poorly assessed despite the high frequency at which it is diagnosed. Our findings suggest that history of any kind of anal surgery is a risk factor for further onset of anal fistula. Surgeons and patients must be informed of this issue.

Citations

Citations to this article as recorded by

Treatment of Hemorrhoid in Unusual Condition-Pregnancy
Hyo Seon Ryu
The Ewha Medical Journal.2022;[Epub] CrossRef
Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study
Sarah Taieb, Patrick Atienza, Jean-David Zeitoun, Milad Taouk, Josée Bourguignon, Christian Thomas, Nabila Rabahi, Saliha Dahlouk, Anne-Carole Lesage, David Lobo, Isabelle Etienney
Annals of Coloproctology.2022; 38(5): 370. CrossRef

Long-term Outcome of a Fissurectomy: A Prospective Single-Arm Study of 50 Operations out of 349 Initial Patients: Jean-David Zeitoun, Pierre Blanchard, Nadia Fathallah, Paul Benfredj, Nicolas Lemarchand, Vincent de Parades; Ann Coloproctol. 2018;34(2):83-87. Published online April 30, 2018; DOI: https://doi.org/10.3393/ac.2017.06.12

12,924 View
173 Download
19 Web of Science
19 Citations

Abstract PDF

Purpose
The surgical standard of care for patients with chronic anal fissure is still disputed. We aimed to assess the natural course of idiopathic anal fissure and the long-term outcome of a fissurectomy as a surgical treatment.
Methods
All consecutive patients referred to a single expert practitioner in a tertiary centre were primarily included. A fissurectomy was proposed in cases of refractory symptoms after 4 to 6 weeks of standard medical management. Only patients with idiopathic and noninfected anal fissures were included in this second subsample to undergo surgery. Conventional postoperative management was prescribed for all patients who had undergone surgery. The main outcome measures were the success rate (defined as a combination of wound healing and relief of pain) and postoperative anal continence.
Results
Three hundred forty-nine patients were primarily recruited. Fifty patients finally underwent surgery for an idiopathic and noninfected fissure. Among them, 47 (94%) were cured at the end of primary follow-up, and 44 of the 47 (93.6%) could be confirmed as being sustainably cured in the longer-term follow-up. The mean time of complete healing was 10.3 weeks (range, 5.7–36.4 weeks). All patients were free of pain at weeks 42. The continence score after surgery was not statistically different from the preoperative score.
Conclusion
A fissurectomy for the treatment of patients with an idiopathic noninfected fissure is associated with rapid pain relief and a high success rate even though complete healing may often be delayed. Moreover, it appears to have no adverse effect on continence.

Citations

Citations to this article as recorded by

Belgian consensus guideline on the management of anal fissures
P Roelandt, G Bislenghi, G Coremans, D De Looze, M.A. Denis, H De Schepper, P Dewint, J Geldof, I Gijsen, N Komen, H Ruymbeke, J Stijns, M Surmont, D Van de Putte, S Van den Broeck, B Van Geluwe, J Wyndaele
Acta Gastro Enterologica Belgica.2024; 87(2): 304. CrossRef
Use of Botulinum Toxin Injections for the Treatment of Chronic Anal Fissure: Results From an American Society of Colon and Rectal Surgeons Survey
Daniel J. Borsuk, Adam Studniarek, John J. Park, Slawomir J. Marecik, Anders Mellgren, Kunal Kochar
The American Surgeon™.2023; 89(3): 346. CrossRef
New Findings at the Internal Anal Sphincter on Cadaveric Dissection and Review of Sphincter-Related Surgery in a Newer Prospective
Aswini Kumar Pujahari
Indian Journal of Surgery.2023; 85(3): 585. CrossRef
Pelvic floor physical therapy in patients with chronic anal fissure: long-term follow-up of a randomized controlled trial
Daniëlle A. van Reijn-Baggen, Henk W. Elzevier, H. Putter, Rob C. M. Pelger, Ingrid J. M. Han-Geurts
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Fissurectomy with mucosal advancement flap anoplasty: The end of a dogma?
M. Skoufou, J.H. Lefèvre, A. Fels, N. Fathallah, P. Benfredj, V. de Parades
Journal of Visceral Surgery.2023; 160(5): 330. CrossRef
Fissurectomy versus lateral internal sphincterotomy in the treatment of chronic anal fissures: no advantages in terms of post-operative incontinence
Roberta Tutino, Casimiro Nigro, Flavia Paternostro, Rosa Federico, Giacomo Lo Secco, Gaetano Gallo, Mauro Santarelli, Gianfranco Cocorullo, Sebastiano Bonventre
Techniques in Coloproctology.2023; 27(10): 885. CrossRef
The Italian Unitary Society of Colon-proctology (SIUCP: Società Italiana Unitaria di Colonproctologia) guidelines for the management of anal fissure
Antonio Brillantino, Adolfo Renzi, Pasquale Talento, Francesca Iacobellis, Luigi Brusciano, Luigi Monaco, Domenico Izzo, Alfredo Giordano, Michele Pinto, Corrado Fantini, Marcello Gasparrini, Michele Schiano Di Visconte, Francesca Milazzo, Giovanni Ferrer
BMC Surgery.2023;[Epub] CrossRef
La fissurectomie avec anoplastie muqueuse : la fin d’un dogme ?
Maria Skoufou, Jérémie H. Lefèvre, Audrey Fels, Nadia Fathallah, Paul Benfredj, Vincent de Parades
Journal de Chirurgie Viscérale.2023; 160(5): 363. CrossRef
Modified open posterior internal sphincterotomy with sliding skin graft for chronic anal fissure and anal stenosis: Low recurrence rate and no serious faecal incontinence postoperative complication
Y. Iida, K. Honda, R. Iida, H. Saitou, Y. Munemoto, A. Tanaka, H. Tanaka
Journal of Visceral Surgery.2022; 159(4): 267. CrossRef
Sphinctérotomie interne postérieure modifiée avec un lambeau cutané pour fissure anale et sténose anale : peu de récidives et d’incontinence anale
Y. Iida, K. Honda, R. Iida, H. Saitou, Y. Munemoto, A. Tanaka, H. Tanaka
Journal de Chirurgie Viscérale.2022; 159(4): 283. CrossRef
Injection of botulinum toxin significantly increases efficiency of fissurectomy in the treatment of chronic anal fissures
Philip Roelandt, Georges Coremans, Jan Wyndaele
International Journal of Colorectal Disease.2022; 37(2): 309. CrossRef
Clinical Trial Combining Botulinum Toxin A Injection and Fissurectomy for Chronic Anal Fissure: A Dose-Dependent Study
Nuha Alsaleh, Abdullah I. Aljunaydil, Gaida A. Aljamili
Journal of Coloproctology.2022; 42(02): 167. CrossRef
Fisurectomy and anoplasty with botulinum toxin injection in patients with chronic anal posterior fissure with hypertonia: a long-term evaluation
Beatrice D’Orazio, Girolamo Geraci, Guido Martorana, Carmelo Sciumé, Giovanni Corbo, Gaetano Di Vita
Updates in Surgery.2021; 73(4): 1575. CrossRef
The comparison between the medical and the surgical management of chronic anal fissures
Navneet Mishra, Kamal Kishore Parmar, Tanweerul Huda
Journal of Clinical and Investigative Surgery.2021; 6(1): 11. CrossRef
Anocutaneous advancement flap provides a quicker cure than fissurectomy in surgical treatment for chronic anal fissure—a retrospective, observational study
Edgar Hancke, Katrin Suchan, Knut Voelke
Langenbeck's Archives of Surgery.2021; 406(8): 2861. CrossRef
Fissurectomy Versus Lateral Internal Sphincterotomy in the Treatment of Chronic Anal Fissure: A Randomized Control Trial
Bipin Kishore Bara, Sujit Kumar Mohanty, Satya Narayan Behera, Ashok Kumar Sahoo, Santanu Kumar Swain
Cureus.2021;[Epub] CrossRef
Botulinum toxin associated with fissurectomy and anoplasty for hypertonic chronic anal fissure: A case-control study
Beatrice D'Orazio, Girolamo Geraci, Fausto Famà, Gloria Terranova, Gaetano Di Vita
World Journal of Clinical Cases.2021; 9(32): 9722. CrossRef
Scanner-Assisted CO2 Laser Fissurectomy: A Pilot Study
Iacopo Giani, Tommaso Cioppa, Chiara Linari, Filippo Caminati, Paolo Dreoni, Gianni Rossi, Cinzia Tanda, Giuseppina Talamo, Federico Bettazzi, Alessandra Aprile, Silvia Grassi, Antonella Pede, Luca Giannoni, Claudio Elbetti
Frontiers in Surgery.2021;[Epub] CrossRef
Fissurectomy combined with botulinum toxin A: a review of short- and long-term efficacy of this treatment strategy for chronic anal fissure; a consecutive proposal of a treatment algorithm for chronic anal fissure
M. Trzpis, J. M. Klaase, R. H. Koop, P. M. A. Broens
coloproctology.2020; 42(5): 400. CrossRef

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