Effectiveness Of Sclerotherapy Research Articles

Effectiveness of Sclerotherapy as “Bridge Treatment” For Third- and Fourth- Degree Hemorrhoids

Journal of the American College of Surgeons 236(5):p S16, May 2023. | DOI: 10.1097/01.XCS.0000932368.21467.4f

Effectiveness of Foam Sclerotherapy in Treatment of Symptomatic Haemorrhoidal Diseases at a Tertiary Care Hospital, Agra, Uttar Pradesh, India: A Prospective Interventional Study

Introduction: Haemorrhoids is a very common condition in patients presenting to surgery Outpatient Department (OPD) with complaints of bleeding per rectum. Injection Foam Sclerotherapy has been established as a safe, simple and effective non surgical modality in treatment of symptomatic grade 1 and 2 haemorrhoids. Aim: To evaluate the effectiveness of foam sclerotherapy as a treatment modality in patients suffering with symptomatic Grade I and II Haemorrhoidal diseases. Materials and Methods: This prospective interventional study was conducted in General Surgery department of FH Medical College and Hospital, Agra, Uttar Pradesh, India between April 2021 to September 2021. A total of 42 patients with complaints of bleeding per rectum, and who were diagnosed as a case of Grade I or II internal haemorrhoids were included. 3% Polidocanol was used as the sclerosing agent for sclerotherapy. Effectiveness of sclerotherapy was evaluated, parameters assessed were bleeding per rectum, pain and pruritis with regular follow-ups of the patients at specific intervals. Results: Among 42 patients 29 (69.05%) patients had grade I haemorrhoids while 13 (30.95%) presented as a case of grade II haemorrhoidal disease. Among the patients with grade I haemorrhoids, 82.76% (24/29) were treated successfully after a single session of foam sclerotherapy while 53.85% (7/13) of the patients with grade II haemorrhoids were symptomatically relieved after a single session. The success rate after 2nd session of sclerotherapy was 100% (29/29) in patients diagnosed as a case of grade I haemorrhoids comparing it to 69.23% (9/13) in those with grade II haemorrhoids. The overall cure rate for either grade of haemorrhoid after three sessions of therapy was 95.24% (40/42). Conclusion: This study reflects that 3% polidocanol when used as a sclerosant agent was found to be cheap, safe and effective, and first line treatment modality in grade I and II haemorrhoids that can be done on outpatient basis with minimal complication.

Comparative Analysis of Sclerotherapy with Bleomycin Versus Surgical Resection for Cystic Hygroma in Children

Objective: Main purpose of this study is to compare the outcomes of sclerotherapy with bleomycin versus surgical resection in children with cystic hygroma. Study Design: Comparative/Observational study Place and Duration: This observational study was conducted at Children Surgical Hospital, Sialkot for six months during the period from July 2020 to December 2020. Methods: Total 50 children of both genders were presented. Children were aged between 2-12 years. All the patients had cystic hygroma were included. Informed written consent was taken from parents of children for detailed demographics. Patients were equally divided into two groups, group I had 25 patients and received sclerotherapy with bleomycin and group II received surgical resection among 25 cases. Post-treatment outcomes were assessed and compared in terms of efficacy and recurrence among both groups. SPSS 22.0 version was used to analyze complete data. Results: Majority were males in group I and II (68% and 64%) and females were 8 (32%) in group I and 9 (36%) in group II. In group I 18 (72% cases) were <6years of age and in group II 19 (76%) children were < 6years of age. Neck and axilla was the most effected site of cystic hygroma followed by face and trunk. We found that effectiveness of sclerotherapy with bleomycin was higher among 21 (84%) cases as compared to surgical resection 19 (76%). Recurrence rate was higher in group II 5 (20%) as compared to group I 3 (12%). Wound infection was lower in group I 1 (4%) and in group II we found 3 (12%). Conclusion: In this research we concluded that use of sclerotherapy with bleomycin is an effective and safe treatment for cystic hygroma as compared to surgical resection in terms of less recurrence rate, wound infection and higher number of good results. Keywords: Cystic hygroma, Children, Sclerotherpay, Bleomycin, Surgical Resection

Tratamento de hemangioma em mucosa labial por escleroterapia – Relato de caso clínico

O hemangioma é uma lesão vascular, podendo representar-se como uma neoplasia benigna dos vasos sanguíneos, relativamente rara na cavidade oral, podendo causar prejuízo estético e funcional a depender da sua região. Sua localização mais frequente é o lábio superior, mas pode ocorrer em outras regiões, como língua, mucosa jugal e palato. O seu tratamento depende, principalmente, do correto diagnóstico da lesão, bem como da localização anatômica da mesma e pode ser realizado com esclerose química, crioterapia, laserterapia, excisão cirúrgica convencional, embolia arterial ou eletrocautério. O objetivo desse trabalho é apresentar um caso clínico, de um paciente do gênero masculino, 63 anos de idade, apresentando hemangioma desde os 16 anos de idade, com recidiva há dez anos em lábio superior. Ao exame físico intrabucal observou-se uma lesão tumoral, de coloração arroxeada, base séssil, assintomática, com limites bem definidos, medindo aproximadamente 4 cm em seu maior diâmetro, localizada na mucosa labial superior. Foi realizada manobra de vitropressão que apresentou um esmaecimento da coloração arroxeada, permitindo diagnóstico clínico de hemangioma. O tratamento proposto foi a esclerose terapêutica com cinco aplicações de oleato de monoetanolamina 5%, considerando as características clínicas e os métodos de diagnóstico desta lesão. Por meio de um diagnóstico preciso e uma conduta terapêutica adequada, o caso apresenta-se com um acompanhamento de dois meses com significativa redução até o momento, e com um resultado estético funcional satisfatório. Conclui-se que a eficácia da escleroterapia realizada com o uso do oleato de monoetanolamina 5% é uma alternativa terapêutica segura.

Effectiveness of Sclerotherapy in Treatment of Patients with Primary Aneurysmal Bone Cysts at King Abdulaziz Medical City (KAMC)

Effectiveness of Sclerotherapy in Treatment of Patients with Primary Aneurysmal Bone Cysts at King Abdulaziz Medical City (KAMC)

Sodium Tetradecyl Sulfate Sclerotherapy for Venous Malformation of the Tongue: A Single-Center Experience

Abstract Purpose To study the safety and effectiveness of sclerotherapy with 3% sodium tetradecyl sulfate (STS) in the management of venous malformation (VM) of the tongue. Materials and Methods The clinical and imaging data of patients with tongue VM treated with STS sclerotherapy over a period of 15 years (2002–2017) were reviewed. Safety was assessed based on the incidence of minor and major complications. Effectiveness was assessed by clinical improvement (reduction in symptoms and size) on a 10-point scale. Results The study included 44 patients (26 men and 18 women). The median age was 24 years at the time of treatment. Eight patients were lost to follow-up. Four patients (4 of 44, 9%) had complications including venous bleeding needing compression, self-limiting hematuria, significant swelling of the tongue requiring prolonged intubation, and arterial bleeding due to injury to the lingual artery. Clinical improvement was seen in 30 (30 of 36, 83%). The median clinical improvement was 4.5 on the 10-point scale, with a range of 1 to 8. Twelve (12 of 36, 33.3%) patients demonstrated 1 to 40% improvement in the lesion size and 18 (50%) had 41 to 80% improvement. Conclusion Sclerotherapy with 3% STS is safe and effective in treating venous malformations of the tongue with minimal complications.

Application of sclerotherapy in small vessel diseases

Sclerotherapy, an effective technique for the treatment of vasodilatation, exerts its therapeutic and cosmetic effects by injecting sclerosing agents into blood vessels to make them into fibrous stripes followed by absorption by surrounding tissues. Sclerotherapy is the first choice for the treatment of dilated intradermal venules, including reticular varicosities and telangiectasia, and also has good therapeutic effects on low-flow vascular malformations. Many factors can affect clinical effects of sclerotherapy, such as types of sclerosing agents, stability of foamed sclerosants and injection methods. With extensive application of sclerosing agents in clinic and improvement of the technology of manufacturing sclerosing foam, the working concentration and dosage of some sclerosing agents have reached a consensus. With development in sclerotherapy and application of newly-emerging technology such as imaging techniques, some progress in sclerotherapy has been made, providing deeper insights into the effectiveness and safety of sclerotherapy. Key words: Blood vessels; Telangiectasis; Vascular malformations; Sclerotherapy; Therapeutic uses

Effectiveness of sclerotherapy in the treatment of haemorrhoids

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Rybak Z, Popow A, Kuczewski P, Korzekwa P. Effectiveness of sclerotherapy in the treatment of haemorrhoids. Phlebological Review. 2016;24(1):25-28. doi:10.5114/pr.2016.61535. APA Rybak, Z., Popow, A., Kuczewski, P., & Korzekwa, P. (2016). Effectiveness of sclerotherapy in the treatment of haemorrhoids. Phlebological Review, 24(1), 25-28. https://doi.org/10.5114/pr.2016.61535 Chicago Rybak, Zbigniew, Andrzej Popow, Paweł Kuczewski, and Piotr Korzekwa. 2016. "Effectiveness of sclerotherapy in the treatment of haemorrhoids". Phlebological Review 24 (1): 25-28. doi:10.5114/pr.2016.61535. Harvard Rybak, Z., Popow, A., Kuczewski, P., and Korzekwa, P. (2016). Effectiveness of sclerotherapy in the treatment of haemorrhoids. Phlebological Review, 24(1), pp.25-28. https://doi.org/10.5114/pr.2016.61535 MLA Rybak, Zbigniew et al. "Effectiveness of sclerotherapy in the treatment of haemorrhoids." Phlebological Review, vol. 24, no. 1, 2016, pp. 25-28. doi:10.5114/pr.2016.61535. Vancouver Rybak Z, Popow A, Kuczewski P, Korzekwa P. Effectiveness of sclerotherapy in the treatment of haemorrhoids. Phlebological Review. 2016;24(1):25-28. doi:10.5114/pr.2016.61535.

Effectiveness of Sclerotherapy, Surgery, and Laser Therapy in Patients With Venous Malformations: A Systematic Review

Because the best possible treatment for venous malformations is unclear, this study systematically reviews the available literature regarding the effectiveness of different treatment options for the patient group. Venous malformations result from incorrect development of the veins during embryogenesis and are present at birth. Venous malformations may exhibit symptoms, such as pain, swelling, and inflammation of the vessel. A systematic literature search in PubMed and Embase was performed. Data regarding the design, participants, intervention and, treatment outcome (success and complications) were extracted. The validity of the studies was assessed with the Cochrane Collaboration's risk of bias tool. Thirty-five studies were identified studying the effectiveness of eight treatments: sclerotherapy/embolization with ethanol, gelified ethanol, bleomycin, polidocanol, sodium tetradecyl sulfate (STS), Ethibloc, surgery, and laser therapy. All of the included studies have a high or unclear risk of bias. The average biased reported success rates for ethanol, gelified ethanol, bleomycin, polidocanol, STS, Ethibloc, surgery, and laser therapy were 74, 89, 88, 90, 86, 65, 90, and 94%, respectively. Until more valid evidence is available, the choice for treatment remains a shared decision between the patient and a multidisciplinary treatment group. From a cost perspective, sclerotherapy with STS or polidocanol should be the treatment of choice.

Effectiveness of Sclerotherapy with Ethanol Amine Oleate in Benign Oral and Perioral Vascular Lesions

Background: Vascular lesions presentation very with age & anatomical location. There are no parameters to assess its therapeutic efficacy. Objective: This prospective experimental study was designed to find out the effectiveness of Sclerotherapy with Ethanol Amine Oleate in the treatment of Benign Oral and Perioral Vascular Lesions. Methods: In this study, 32 patients, aged 1½ to 40 years with oral and perioral vascular lesions were included. Diagnosis was made by accurate history, clinical examination and in some cases Color Doppler examination, MRI and/or Angiogram were done for confirmation. Intralesional injection of Ethanol Amine Oleate was given at an interval of 2weeks between each session. Photographs were also taken during subsequent session to document the effect of injection. Results: At 8weeks after the final Sclerotherapeutic session, the results were graded as: Excellent: for extinguished and symmetrical appearance obtained; Good: for definitive reduction obtained; Fair: for slight reduction obtained and Poor: for lesion unchanged or worsened. Results with grades, excellent and good are considered effective. The efficacy of the treatment was evaluated 8 weeks after the final Sclerotherapeutic session. Out of 32 patients, 34.4% had excellent result, 53.1% had good result, 6.3% had fair result and 6.3% had poor result. Conclusion: Sclerotherapy with Ethanol Amine Oleate is a safe and less invasive method with minimal risk to the patient. It can be the treatment of choice for symptomatic Vascular lesions. Key words: Vascular Lesions (VLs); Sclerotherapy; Ethanol Amine Oleate (EAO). DOI: http://dx.doi.org/10.3329/bsmmuj.v4i2.8641 BSMMU J 2011; 4(2):110-115

Treatment of lymphangioma in children: our experience of 128 cases

Purpose The aim of this study is to investigate the optimal treatment for lymphangioma in children by analyzing the effectiveness and complications of treatment modalities. Methods We reviewed 128 patients with lymphangioma treated at our institution between 1979 and 2005. Periods of treatment were divided arbitrarily into 2 groups: period I, from 1979 to 1988 (n = 53); and period II, from 1989 to 2005 (n = 75). According to radiological appearance, patients were grouped into 4 types: single cystic (SI; n = 23), macrocystic (MA; n = 11), microcystic (MI; n = 69), and cavernous (CA; n = 25). Results Sclerotherapy as primary treatment was performed in only 2 patients (3.8%) in period I using bleomycin but increased significantly in period II to 48 patients (64.0%) using OK-432 ( P < .01). Nevertheless, primary surgical excision (69/78 patients, 88.5%) was significantly more successful than sclerotherapy (32/50, 64.0%) ( P < .01). The following are the locations and types of lesions: head/neck (n = 69; SI, 11; MA, 5; MI, 42; CA, 11), trunk (n = 34; SI, 6; MA, 6; MI, 15; CA, 7), and extremities/other (n = 25; SI, 6; MI, 12; CA, 7). The effectiveness of sclerotherapy in SI, MA, MI, and CA types was 90.9%, 100%, 68.0%, and 10.0%, respectively. Seventeen patients (SI, 1; MI, 8; CA, 8) who received primary sclerotherapy required surgical excision with good outcome. Complications after primary surgical excision were more serious compared with sclerotherapy. Conclusion Sclerotherapy with OK-432 was not as effective as reported in the literature. We recommend OK-432 injection therapy alone for SI and MA types and surgical excision after pretreatment with OK-432 for MI and CA types.

Treatment of branchial cleft cyst with intracystic injection of OK-432

Conclusions. The data suggest that branchial cleft cyst (BCC) can be primarily treated with OK-432 sclerotherapy and only the remaining lesions with excision. Objectives: To evaluate the effectiveness of sclerotherapy using OK-432 in the treatment of BCC. Materials and methods. We treated 12 BCC patients (3 males and 9 females; mean age 25 years) with OK-432 sclerotherapy at an outpatient clinic. The cystic fluids were aspirated and diagnosed by cytomorphology and DNA cytometric analysis to exclude malignancy. The fluid aspirated from the cyst was replaced with an equal volume of OK-432 solution. The sizes of cysts were measured and compared before and after injection. The remaining cysts were excised and histopathologically compared with the excised BCCs that had not been treated with OK-432. Results. Seven of 12 patients (58%) showed a complete response after OK-432 injection, administered one to three times. Three patients (25%) had only partial response and two (17%) were stationary. Five patients with remaining lesions underwent excision. There was no difficulty in dissecting around the cysts and no increased morbidity during operation. None of the patients had evidence of recurrences or malignancies developing during the follow-up period (mean 21 months, range 17–26 months). There were no major side effects except fever after sclerotherapy.

Craniofacial Cavernous Venous Malformations: Percutaneous Sclerotherapy with Use of Ethanolamine Oleate

To assess the efficacy of percutaneous sclerotherapy with use of ethanolamine oleate for craniofacial cavernous venous malformations. From 1991 to 2001, sclerotherapy (average of two procedures per patient) was performed in 29 patients (mean age, 22 y; 10 male) with craniofacial venous malformations. Direct puncture venography was performed with use of water-soluble contrast media to delineate the extent of the lesions. CO(2) gas was used as contrast medium in addition to water-soluble contrast media in five patients in whom lesions had large nondependent areas. Coil embolization with a transvenous approach was performed in two patients when the lesions had large draining veins. Then, a mixture of 5% ethanolamine oleate and iodized oil (ratio, 5:1-5:2) was injected manually into the lesions under fluoroscopic guidance to monitor the process. A total of 59 procedures were performed. Clinical follow-up was obtained in 25 of 29 patients. The duration of follow-up ranged from 10 days to 6 years (mean, 8.5 mo). The effectiveness of sclerotherapy was assessed on the basis of clinical, surgical, and radiologic findings. The procedures were effective in 14 of 16 patients who underwent sclerotherapy only. The procedures were beneficial for all nine patients who underwent sclerotherapy and surgery. There was no skin injury or nerve damage. The trismus that appeared in two patients with lesions in the masticator space was treated well by conservative therapy. Percutaneous sclerotherapy with use of ethanolamine oleate is a safe and effective treatment of craniofacial cavernous venous malformations. However, renal function was not specifically evaluated after treatment, and therefore occult renal dysfunction cannot be excluded.

Sclerotherapy with tetracycline solution for hydrocele

A study of sclerotherapy for hydrocele using different concentrations (10%, 5%, 2.5%)for tetracycline solution was done on 24 patients, 23 patients were cured. The effectiveness of sclerotherapy was the same for the three groups of patients with use of each different concentration of the solution. Pain was the only adverse effect. Nonspecific cellular foreign body reaction and fibrin strand proliferation were observed in the hydrocele fluid after this procedure. We consider sclerotherapy for hydrocele with tetracycline solution safe and the procedure of choice for patients in whom surgery or anesthesia is contraindicated, for patients who refuse surgery, and for economic reasons.