Annals of Coloproctology

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Comparison of Early Clinical Outcomes Between ALTA (Aluminum Potassium Sulfate and Tannic Acid, Ziohn(R)) Injection Therapy and a Submucosal Hemorrhoidectomy in Patients with Internal Hemorrhoids.: Lee, Young Chan , Shin, Hyun Keun , Lim, Cheong Ho , Yang, Hyung Kyu , Kang, Jung Hyun , Lee, Kang Young , Kim, Nam Kyu; J Korean Soc Coloproctol. 2010;26(3):179-185.; DOI: https://doi.org/10.3393/jksc.2010.26.3.179

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PURPOSE
The purpose of this study was to evaluate early outcomes of ALTA (aluminum potassium sulfate and tannic acid, Ziohn(R)) injection compared with those of a submucosal hemorrhoidectomy for the treatment of internal hemorrhoids.
METHODS
From September 2008 to April 2009, a total of 50 patients who had internal hemorrhoids (Golliger grade II to IV) were treated by using either ALTA injection (n=25) or a submucosal hemorrhoidectomy (n=25). Outcomes with respect to pain scores, analgesics use, and satisfaction levels of the patients, and complications were compared.
RESULTS
The mean number of hemorrhoidal piles was 3.52 in the ALTA injection group and 3.56 in the operation group. The average amount of ALTA injection was 27.34 cc. Pain scores measured at one day and 7 days after the treatment, and the number of analgesics used in the injection group were significantly lower than those in the operation group (P<0.001). However, there was no significant difference in the satisfaction level between two groups. One case of treatment failure was found in the ALTA injection group. There was no difference in complications between the injection group (n=4) and the operation group (n=5) (P=0.725).
CONCLUSION
When compared with a submucosal hemorrhoidectomy, ALTA injection showed less post-treatment pain and less analgesics use. Overall complication rates were not different between the two groups. We found the early outcomes of ALTA injection for the treatment of internal hemorrhoids to be comparable to those of surgery. Thus, large-scale and long-term follow-up studies are needed to clarify the proper indications for ALTA injection.

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Aluminum Potassium Sulfate and Tannic Acid Injection for Hemorrhoids
Seok Won Lim
Journal of the Korean Society of Coloproctology.2012; 28(2): 73. CrossRef

Complication of the Hemorrhoid Treatment by Sclerotherapy.: Lee, Dong Shik , Shim, Min Chul , Kim, Jae Hwang; J Korean Soc Coloproctol. 1997;13(3):443-450.

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Abstract PDF: The technique of the sclerotherapy for hemorrhoid treatment was introduced in the late 19th century. The sclerotherapy is a simple method with lesser pain or complication, in case of being operated with an exact indication. But the fact is that this sclerotherapy is used imprudently and secretly by quack, owing to misunderstanding of its simplicity. This thesis is a clinical analysis of 575 patients who were diagnosed hemorrhoids, anal stenosis, anal incontinence and admitted from Jan. 1994 to Dec. 1995. 99 patients(17.1%) of them were taken sclerotherapy Previously The Peak incidence was in the 4th decade of male(41.8%) and the 5th decade of female(40.6%). From five to ten years of the time lapse between onset of symptoms and admission was 27.3% and it appeared most frequently. It seems that the incompleteness of the first treatment cased the extension of illness period to the patients. The most frequent complaint was prolapse(72.7%). The 3rd and 4th degree of hemorrhoid were 58.5%. Combined diseases were anal stenosis(22.2%), fissure and skin tag(16.1%), and rectocele(11.1%). Owing to incompleteness of the sclerotherapy, the degree and symptoms of hemorrhoids were more severe than the general hemorrhoids and combined diseases also were more complicated. So conservative treatment and non-surgical treatment were impossible, and Left lateral internal sphinterotomy, rectopexcy, anoplasty, fistulotomy, sphinteroplasty, colostomy with hemorrhoidectomy performed. but the treatment itself was more complex and difficult. In conclusion, it is thought that the national and positive medical education about hemorrhoids and the controls about the abnormal treatment are needed.

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