Classification and guidelines of hemorrhoidal disease: Present and future

Michele Rubbini, Simona Ascanelli, Michele Rubbini, Simona Ascanelli

Abstract

Classification and guidelines of hemorrhoidal disease are based on the subdivision in Grades of prolapse followed by any aspect related to both the treatment and its technique. When taking the proposals for classification and guidelines issued by prolific scientific societies into consideration, it is evident that strong contradictions and interpretative limits emerge in finding the best treatment to be adopted. After a critical examination of these limitations, a methodological proposal is shared to achieve a new classification, which plays a part in forming a new guideline for hemorrhoidal disease, identifying its evolution, dynamism of the prolapse, symptomatology, enteropathogenesis and gender characteristics.

Keywords: Calssification; Gender; Guidelines; Hemorrhoids.

Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

References

    1. Sun Z, Migaly J. Review of Hemorrhoid Disease: Presentation and Management. Clin Colon Rectal Surg. 2016;29:22–29. doi: 10.1055/s-0035-1568144.
    1. Jacobs DO. Hemorrhoids: what are the options in 2018? Curr Opin Gastroenterol. 2018;34:46–49. doi: 10.1097/MOG.0000000000000408.
    1. Chen HL, Woo XB, Cui J, Chen CQ, Peng JS. Ligasure versus stapled hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials. Surg Laparosc Endosc Percutan Tech. 2014;24:285–289. doi: 10.1097/SLE.0000000000000009.
    1. Watson AJ, Cook J, Hudson J, Kilonzo M, Wood J, Bruhn H, Brown S, Buckley B, Curran F, Jayne D, Loudon M, Rajagopal R, McDonald A, Norrie J. A pragmatic multicentre randomised controlled trial comparing stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease: the eTHoS study. Health Technol Assess. 2017;21:1–224. doi: 10.3310/hta21700.
    1. Simillis C, Thoukididou SN, Slesser AA, Rasheed S, Tan E, Tekkis PP. Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg. 2015;102:1603–1618. doi: 10.1002/bjs.9913.
    1. Goligher JC. London: Ballierè Tindal; 1980. Surgery of the Anus, Rectum and Colon. 4th Edition.
    1. Jacobs D. Clinical practice. Hemorrhoids. N Engl J Med. 2014;371:944–951. doi: 10.1056/NEJMcp1204188.
    1. Lunniss PJ, Mann CV. Classification of internal haemorrhoids: a discussion paper. Colorectal Dis. 2004;6:226–232. doi: 10.1111/j.1463-1318.2004.00590.x.
    1. Morgado PJ, Suárez JA, Gómez LG, Morgado PJ., Jr Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum. 1988;31:474–480.
    1. Gerjy R, Lindhoff-Larson A, Nyström PO. Grade of prolapse and symptoms of haemorrhoids are poorly correlated: result of a classification algorithm in 270 patients. Colorectal Dis. 2008;10:694–700. doi: 10.1111/j.1463-1318.2008.01498.x.
    1. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist's view. World J Gastroenterol. 2015;21:9245–9252. doi: 10.3748/wjg.v21.i31.9245.
    1. Elbetti C, Giani I, Novelli E, Fucini C, Martellucci J. The single pile classification: a new tool for the classification of haemorrhoidal disease and the comparison of treatment results. Updates Surg. 2015;67:421–426. doi: 10.1007/s13304-015-0333-0.
    1. Rubbini M, Ascanelli S, Fabbian F. Hemorrhoidal disease: is it time for a new classification? Int J Colorectal Dis. 2018;33:831–833. doi: 10.1007/s00384-018-3060-4.
    1. Nyström PO, Qvist N, Raahave D, Lindsey I, Mortensen N Stapled or Open Pile Procedure (STOPP) trial study group. Randomized clinical trial of symptom control after stapled anopexy or diathermy excision for haemorrhoid prolapse. Br J Surg. 2010;97:167–176. doi: 10.1002/bjs.6804.
    1. Rørvik HD, Styr K, Ilum L, McKinstry GL, Dragesund T, Campos AH, Brandstrup B, Olaison G. Hemorrhoidal Disease Symptom Score and Short Health ScaleHD: New Tools to Evaluate Symptoms and Health-Related Quality of Life in Hemorrhoidal Disease. Dis Colon Rectum. 2019;62:333–342. doi: 10.1097/DCR.0000000000001234.
    1. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018;61:284–292. doi: 10.1097/DCR.0000000000001030.
    1. Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014;109:1141–57; (Quiz) 1058. doi: 10.1038/ajg.2014.190.
    1. Clinical Practice Committee, American Gastroenterological Association. American Gastroenterological Association medical position statement: Diagnosis and treatment of hemorrhoids. Gastroenterology. 2004;126:1461–1462.
    1. Yamana T. Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids. J Anus Rectum Colon. 2017;1:89–99. doi: 10.23922/jarc.2017-018.
    1. Altomare DF, Roveran A, Pecorella G, Gaj F, Stortini E. The treatment of hemorrhoids: guidelines of the Italian Society of Colorectal Surgery. Tech Coloproctol. 2006;10:181–186. doi: 10.1007/s10151-006-0277-y.
    1. Higuero T, Abramowitz L, Castinel A, Fathallah N, Hemery P, Laclotte Duhoux C, Pigot F, Pillant-Le Moult H, Senéjoux A, Siproudhis L, Staumont G, Suduca JM, Vinson-Bonnet B. Guidelines for the treatment of hemorrhoids (short report) J Visc Surg. 2016;153:213–218. doi: 10.1016/j.jviscsurg.2016.03.004.
    1. Agarwal N, Singh K, Sheikh P, Mittal K, Mathai V, Kumar A. Executive Summary - The Association of Colon & Rectal Surgeons of India (ACRSI) Practice Guidelines for the Management of Haemorrhoids-2016. Indian J Surg. 2017;79:58–61. doi: 10.1007/s12262-016-1578-7.
    1. Rubbini M. Traveling through the perineum(s): to the discovery of an old world. Int J Colorectal Dis. 2017;32:729–731. doi: 10.1007/s00384-016-2710-7.

Source: PubMed

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