Abstract
Purpose
Aluminum potassium sulfate and tannic acid (ALTA) induce noninvasive sclerosis and the involution of hemorrhoids by initiating an inflammatory reaction. We assessed the mid-term outcome after ALTA sclerotherapy for symptomatic hemorrhoids.
Methods
Between May 2006 and July 2009, 1210 patients with grade III or IV hemorrhoids underwent surgery at Kunimoto Hospital. Our treatment strategy for internal hemorrhoids is first establishing whether ALTA therapy is possible for the type of hemorrhoid, and then performing either ALTA therapy or alternatively, ligation and excision (LE) for those types unsuitable for ALTA therapy.
Results
A total of 448 patients were treated with ALTA therapy alone (Group A), 706 patients were treated with a combination of ALTA and LE therapy (Group B), and 56 patients were treated with LE alone (Group C). The overall recurrence rates were 3.6% (16/448) and 0.3% (2/706) in Groups A and B, respectively. There was no recurrence in Group C. Rectal ulcers developed at the injection site in four (0.9%) patients from Group A, but they healed within a few months with conservative therapy.
Conclusion
ALTA sclerotherapy is a simple and safe treatment for symptomatic hemorrhoids, with few complications.
Similar content being viewed by others
References
Shalaby R, Desoky A. Randomized clinical trial of stapled with Milligan-Morgan haemorrhoidectomy. Br J Surg 2001;88: 1049–1053.
Yano T, Matsuda Y, Asano M, Kawakami K, Nakai K, Nonaka M, et al. The outcome of postoperative hemorrhaging following a hemorrhoidectomy. Surg Today 2009;39:866–869.
Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S. Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg 2001;88:669–674.
Takano M, Iwadare J, Ohba H, Takamura H, Masuda Y, Matsuo K, et al. Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent. Comparison with ligation and excision. Int J Colorectal Dis 2006;21:44–51.
Hachiro Y, Kunimoto M, Abe T, Kusano M. A new sclerosing therapy for internal hemorrhoids: experience in 200 cases with Zione injection. J Jpn Soc Coloproctol 2006;59:317–321.
Ono T, Goto K, Takagi S, Iwasaki S, Komatsu H. Sclerosing effect of OC-108, a novel agent for hemorrhoids, is associated with granulomatous inflammation induced by aluminum. J Pharmacol Sci 2005;99:353–363.
Shi Z. Xiaozhiling four-step injection in treating hemorrhoids of stages III and IV: a sclerotherapeutic approach of thrombosing branches of artery rectalis superior. Chin J Trad W Med 1997;3: 246–249.
Takamura H, Inatsugu H, Yoshikawa S, Masuda T. Treatment of internal hemorrhoids with Xiaozhiling injection. J Jpn Soc Coloproctol 2001;54:910–914.
Kunimoto M, Abe T, Hachiro Y, Tsuruma T. Treatment of rectal ulcer complicating sclerosing therapy for internal hemorrhoids with Aluminum potassium sulfate tannic acid (ALTA). J Jpn Soc Coloproctol 2007;60:327–332.
Shi Z, Zhou J, He X. On treatment of third degree internal hemorrhoids with “Xiaozhiling” injection. J Trad Chin Med 1981;1: 115–120.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hachiro, Y., Kunimoto, M., Abe, T. et al. Aluminum potassium sulfate and tannic acid (ALTA) injection as the mainstay of treatment for internal hemorrhoids. Surg Today 41, 806–809 (2011). https://doi.org/10.1007/s00595-010-4386-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00595-010-4386-x