The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.

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Publication Details

Journal
Annals of Coloproctology
Published
2024-08-30
DOI
https://doi.org/10.3393/ac.2023.00871.0124
Citations
18
Primary Topic
Anorectal Disease Treatments and Outcomes
Type
article
Field-Weighted Citation Impact
10.31
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article

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

Alessandro Paolo Chiriatti, G Lamanna, Ludovico Docimo, Giovanni Ferreri et al.
18 citations
Annals of Coloproctology
Anorectal Disease Treatments and Outcomes
10.31
article

The Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colonproctologia) guidelines for the management of acute and chronic hemorrhoidal disease

Alessandro Paolo Chiriatti, G Lamanna, Ludovico Docimo, Giovanni Ferreri, Antonio Brescia, Massimo Pezzatini, Francesca Da Pozzo, Alberto Di Leo, Angela Pezzolla, Alessandro Bussotti, Maurizio Grillo, Raffaella Marina Di Renzo, Francesca Iacobellis, Domenico Izzo, Leonardo Lenisa, Giovanna Ioia, Corrado Rispoli, Nando Gallese, Antonio Ferronetti, Massimo Antropoli, Andrea Braini, Michele D’Ambra, G. Marino, Ettore Greco, Corrado Fantini, Nicola Antonacci, Adolfo Renzi, Claudio Gambardella, Fabrizio Foroni, Marta Mozzon, Giuseppe Paolo Ferulano, Lorenzo Asciore, Giacomo Sarzo, Massimiliano Mistrangelo, Mauro Maglio, Federico Maria Mongardini, Luigi Brusciano, Luigi Marano, Domenico de Vito, Sergio Agradi, Antonia Di Sarno, Carmelo Geremia, M Mongardini, Vincenzo Landolfi, Giuseppe Calabrò, E Cudazzo, Vincenzo Bottino, M. V. G. Pinto, Ludovico Carbone, Pasquale Talento, Luigi Monaco, Simona Ascanelli, Pierluigi Bianchi, Antonio Longo, Michele Lanza, Massimiliano Varriale, Riccardo Brachet Contul, Alessio Palumbo, U. Favetta, Matteo Zuin, F. Milazzo, Antonio Brillantino, Marcello Gasparrini, Roberto Rizzato, Patrizia Liguori, Alessandro Stazi, Francesca Babic, Valeria Gianfreda, Michele Schiano di Visconte, Gianmario Edoardo Poto, G. Frezza, Bruno Masci, Giampiero Ucchino, Maria Laura Sandoval Sotelo, Claudio Eduardo Fernando Antonio Pagano, Ilaria Ferrante, L Vicenzo, Umberto Cocozza, Mario Cicconi, Erika Boriani, Giuseppe D’Oriano, Alfredo Giordano, Antonino Tirrò
article en
18 citations

Abstract

The aim of these evidence-based guidelines is to present a consensus position from members of the Italian Unitary Society of Colon-Proctology (Società Italiana Unitaria di Colon-Proctologia, SIUCP) on the diagnosis and management of hemorrhoidal disease, with the goal of guiding physicians in the choice of the best treatment option. A panel of experts was charged by the Board of the SIUCP to develop key questions on the main topics related to the management of hemorrhoidal disease and to perform an accurate and comprehensive literature search on each topic, in order to provide evidence-based answers to the questions and to summarize them in statements. All the clinical questions were discussed by the expert panel in multiple rounds through the Delphi approach and, for each statement, a consensus among the experts was reached. The questions were created according to PICO (patients, intervention, comparison, and outcomes) criteria, and the statements were developed adopting the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology. In cases of grade 1 hemorrhoidal prolapse, outpatient procedures including hemorrhoidal laser procedure and sclerotherapy may be considered the preferred surgical options. For grade 2 prolapse, nonexcisional procedures including outpatient treatments, hemorrhoidal artery ligation and mucopexy, laser hemorrhoidoplasty, the Rafaelo procedure, and stapled hemorrhoidopexy may represent the first-line treatment options, whereas excisional surgery may be considered in selected cases. In cases of grades 3 and 4, stapled hemorrhoidopexy and hemorrhoidectomy may represent the most effective procedures, even if, in the expert panel opinion, stapled hemorrhoidopexy represents the gold-standard treatment for grade 3 hemorrhoidal prolapse.

Annals of ColoproctologyVol. 40(4)
University of Parma (IT), University of Salerno (IT), Humanitas University (IT), University of Campania "Luigi Vanvitelli" (IT), University of Ferrara (IT), Policlinico Umberto I (IT), CTO Hospital (IT), Ospedale Antonio Cardarelli (IT), Azienda Sanitaria Unità Locale di Reggio Emilia (IT), ASL Roma (IT), Ospedale di Cattinara (IT), Fondazione Ricerca Molinette (IT), AULSS 2 Marca Trevigiana (IT), Azienda Unità Sanitaria Locale di Ferrara (IT), Ospedale San Carlo (IT), Ospedale Sant Antonio (IT), Azienda Ospedaliera S.Giuseppe Moscati (IT), Azienda Ospedaliera Santa Maria Degli Angeli (IT), Ospedale San Paolo (IT), Ospedale “M. Bufalini” di Cesena (IT), Ospedale dei Pellegrini (IT), CTO Andrea Alesini (IT), Federico II University Hospital (IT), Humanitas Castelli (IT), Ospedale Madonna Delle Grazie (IT), Azienda Ospedaliera Sant'Andrea (IT), Ospedale Santa Maria della Misericordia di Udine (IT), Casa di cura Pierangeli (IT), IRCCS San Camillo Hospital (IT), University of Aosta Valley (IT), Villa Pineta Hospital (IT), Ospedale Sandro Pertini (IT), Ospedale Monaldi (IT), Ospedale Buon Consiglio Fatebenefratelli (IT), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Prywatna Wyższa Szkoła Nauk Społecznych, Komputerowych i Medycznych (PL), University of Bari Aldo Moro (IT), Sapienza University of Rome (IT)
Good health and well-being
Openalex Percentile: Top 1%
Anorectal Disease Treatments and Outcomes
10.31
DOIOpen Access PDFOpenAlex
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