International journal of colorectal disease · 2026
Early hemodynamic changes following endoscopic sclerotherapy for hemorrhoidal disease assessed by transperineal ultrasound and their relationship with clinical outcomes.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Gravante Gianpiero, De Simone Veronica, Picciariello Arcangelo, Palmieri Francesco, Missaglia Claudio, Sorge Roberto, Sorrenti Salvatore, Sileri Pierpaolo, Gallo Gaetano
Аннотация
BACKGROUND: Polidocanol foam (PF) sclerotherapy has regained interest as a minimally invasive treatment for hemorrhoidal disease (HD). However, the early hemodynamic effects of sclerotherapy and their relationship with clinical outcomes remain poorly defined. This study aimed to evaluate early local hemodynamic changes following endoscopic PF sclerotherapy using transperineal ultrasound (TPUS) and to explore their association with patient-reported outcome measures (PROMs).
METHODS: This prospective observational study included patients with Goligher grade I-IV HD treated with endoscopic PF sclerotherapy. TPUS Doppler assessment of peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) was performed at baseline, 7 days, and 30 days post-treatment. Symptoms were evaluated using the PROM-HISS score. Hemodynamic and clinical outcomes were compared over time and stratified by HD severity (Goligher I-II vs III-IV).
RESULTS: Thirty-seven patients completed follow-up. No significant differences in preoperative PSV were observed between lower- (Goligher I/II) and higher-grade HD (Goligher III/IV). After treatment, patients with lower-grade HD showed a significant reduction in PSV and RI at both 7 and 30 days (p < 0.01), indicating effective modulation of arterial inflow. In contrast, no significant changes in PSV or RI were observed in higher-grade HD, while EDV increased at 30 days (p = 0.012). PROM-HISS scores significantly improved in all patients at 7 days; however, symptom scores increased between 7 and 30 days in higher-grade HD.
CONCLUSIONS: PF sclerotherapy induces early short-term hemodynamic changes detectable by TPUS in lower-grade HD, paralleling consistent short-term symptom improvement. In advanced HD, clinical benefit appears transient and not supported by objective vascular remodeling. TPUS emerges as a valuable non-invasive tool for functional assessment, follow-up, and treatment stratification after sclerotherapy.
METHODS: This prospective observational study included patients with Goligher grade I-IV HD treated with endoscopic PF sclerotherapy. TPUS Doppler assessment of peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistance index (RI) was performed at baseline, 7 days, and 30 days post-treatment. Symptoms were evaluated using the PROM-HISS score. Hemodynamic and clinical outcomes were compared over time and stratified by HD severity (Goligher I-II vs III-IV).
RESULTS: Thirty-seven patients completed follow-up. No significant differences in preoperative PSV were observed between lower- (Goligher I/II) and higher-grade HD (Goligher III/IV). After treatment, patients with lower-grade HD showed a significant reduction in PSV and RI at both 7 and 30 days (p < 0.01), indicating effective modulation of arterial inflow. In contrast, no significant changes in PSV or RI were observed in higher-grade HD, while EDV increased at 30 days (p = 0.012). PROM-HISS scores significantly improved in all patients at 7 days; however, symptom scores increased between 7 and 30 days in higher-grade HD.
CONCLUSIONS: PF sclerotherapy induces early short-term hemodynamic changes detectable by TPUS in lower-grade HD, paralleling consistent short-term symptom improvement. In advanced HD, clinical benefit appears transient and not supported by objective vascular remodeling. TPUS emerges as a valuable non-invasive tool for functional assessment, follow-up, and treatment stratification after sclerotherapy.