Evidence map›Paper›PMID 37133577›Full record

SynthesisInternational journal of colorectal disease2023

HEmoRhoidal disease management with Band ligation versus polidocanol Sclerotherapy: a systematic review and meta-analysis (the HerBS Review).

Janhavi Patel, Tyler McKechnie, Kathy Wu, Sahil Sharma, Yung Lee, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 2 pooled it
5.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Injection sclerotherapy for the treatment of haemorrhoids in anticoagulated patients.Annals of the Royal College of Surgeons of England · 2025
    Article
  11. Review
  12. Article
  13. Article
  14. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Janhavi PatelDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Tyler McKechnieDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Kathy WuMichael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Sahil SharmaDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Yung LeeDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Aristithes DoumourasDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Dennis HongDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Cagla EskiciogluDepartment of General Surgery, McMaster University, Hamilton, ON, Canada. eskicio@mcmaster.ca.
McMaster University · CASt. Joseph’s Healthcare Hamilton · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSymptomatic internal hemorrhoids affect up to 40% of people in Western society. Patients with grade I-III hemorrhoids, who fail lifestyle and medical management, may benefit from office-based procedures. As per the American Society of Colon and Rectum Surgeons (ASCRS), rubber band ligation (RBL) is the first-line office-based treatment. Polidocanol sclerotherapy is a relatively new approach for these patients. The aim of this systematic review is to compare the efficacy of RBL and polidocanol sclerotherapy with the treatment of symptomatic grade I-III internal hemorrhoids.

methodsThe systematic review was completed by searching MEDLINE, Embase, and CENTRAL databases from inception to August 2022 for prospective studies comparing RBL and polidocanol sclerotherapy or evaluating the efficacy of polidocanol sclerotherapy alone for adult (> 18 years) patients with grade I-III internal hemorrhoids. Treatments were evaluated for therapeutic success and post-procedure morbidity.

resultsOf 155 citations obtained, 10 studies (3 comparative and 7 single-arm studies) and 4 abstracts (2 comparative and 2 single arm) were included in the study. The patients undergoing sclerotherapy had a 93% (151/163) therapeutic success rate compared to 75% (68/91) in the RBL group (OR 3.39, 95% CI 1.48-7.74, p < 0.01). The post-procedure morbidity was 8% (17/200) in the sclerotherapy group and 18% (23/128) in the RBL group (OR 0.53, 95% CI 0.15-1.82, p = 0.31).

conclusionThis study highlights that polidocanol sclerotherapy may be associated with higher therapeutic success in patients with symptomatic grade I-III internal hemorrhoids. Further evaluations in the form of randomized trials are required to evaluate patient populations, which may benefit more from sclerotherapy.

Indexed as

HemorrhoidsSclerotherapyAdultDisease ManagementHumansLigationPolidocanolPolyethylene GlycolsProspective StudiesTreatment Outcomedodecylnonaoxyethylene glycol monoetherPolidocanolPolyethylene GlycolsInternal hemorrhoidsMorbidityPolidocanol sclerotherapyRubber band ligationTherapeutic success

Identifiers

PMID37133577
OpenAlexW4367834474

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.