Haemorrhoidal disease

Role of flavonoids in the management of acutely symptomatic haemorrhoids: A systematic review and meta-analysis of randomized, controlled trials (2019)

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Type of publication:
Conference abstract

Author(s):
*Rehman S.; Miles W.; Sains P.; Sajid M.

Citation:
British Journal of Surgery; Sep 2019; vol. 106, S5, p. 110

Abstract:
Aims: The objective of this article is to assess the role of role of flavonoids in the management of acutely
symptomatic haemorrhoids.
Method(s): The data retrieved from the published randomized, controlled trials (RCT) regarding the role of flavonoids in the management of acutely symptomatic haemorrhoids was analysed using the principles of metaanalysis. The summated outcome of dichotomous variables was expressed in odds ratio (OR).
Result(s): Ten RCTs on 1478 patients comparing the surgical outcomes in patients having clinically and endoscopically diagnosed acute symptomatic haemorrhoids after using flavonoids versus placebo preparation were analysed. In the random effects model analysis using the statistical software Review Manager 5.3, the symptomatic relief (OR, 0.48; 95% CI, 0.16, 1.3928; z = 1.36; P = 0.18), satisfaction on pain relief (OR, 0.30; 95% CI, 0.08, 1.07; z = 1.86; P = 0.06), recurrence (OR, 0.48; 95% CI, 0.14, 1.63; z = 1.17; P = 0.24) and complications rate (OR, 1.31; 95% CI, 0.49, 3.54; z = 0.54; P = 0.59) were statistically similar in both groups. However, symptomatic haemorrhoidal bleeding control rate was higher in flavonoids group (OR, 0.33; 95% CI, 0.13, 0.84; z = 2.33; P = 0.02).
Conclusion(s): Use of flavonoids to treat symptomatic acute haemorrhoids failed to demonstrate better effectiveness over traditional placebo remedies except better bleeding control.

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Haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography: a meta-analysis of randomized, controlled trials (2019)

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Type of publication:
Conference abstract

Author(s):
*Rehman S.; Miles W.; Sains P.; Sajid M.; Baig M.

Citation:
British Journal of Surgery; Sep 2019; vol. 106, S5; p. 27-28

Abstract:
Aims: The objective of this article is to compare the surgical outcomes following haemorrhoidal artery ligation
and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography.
Method(s): The data retrieved from the published randomized, controlled trials (RCT) comparing the surgical
outcomes following haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal disease with or
without the use of Doppler ultrasonography (DUS) was analysed using the principles of meta-analysis. The
summated outcome of dichotomous variables was expressed in risk ratio (RR) and continuous data was
presented in standardised mean difference (SMD).
Result(s): Four RCTs on 270 patients comparing the surgical outcomes following haemorrhoidal artery ligation
and/or suture mucopexy for haemorrhoidal disease with or without the use of Doppler ultrasonography were
analysed using the statistical software Review Manager 5.3. In the random effects model analysis no-DUS
group had shorter procedure time (SMD, 3.69; 95% CI, 2.73, 4.64; z = 7.56; P = 0.00001), better symptomatic
relief rate (RR, 1.95; 95% CI, 1.07, 3.56; z = 2.19; P = 0.03) and lower risk of short or long term haemorrhoidal
bleed (RR, 2.27; 95% CI, 1.25, 4.11; z = 2.70; P = 0.0007). The recurrence rate (RR, 1.87; 95% CI, 0.66, 5.30; z =
1.18; P = 0.24), post-operative pain score and complication rate were similar in both groups.
Conclusion(s): The use of DUS in haemorrhoidal artery ligation and/or suture mucopexy for haemorrhoidal
disease is not mandatory and better clinical outcomes may be achieved without its use.

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