Systematic review of foam sclerotherapy for varicose veins (Br J Surg 2007; 94: 925–936)

✍ Scribed by J. R. Scurr; G. L. Gilling-Smith; R. K. Fisher

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 62 KB
• Volume: 94
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.6037

✦ Synopsis

have recurrent haemorrhoids than those with conventional haemorrhoidectomy at 1-2 years: 417 patients, odds ratio (OR) 3•60 (1•24-10•49). Interestingly, for longer follow-up, the number of patients dropped to 120 and the OR was no longer significant (OR 5•11 (0•57-41•17)), presumably because of lack of power.

The same review 3 showed also that there were more haemorrhoidal prolapses following SH (9 studies, 798 patients, OR 2•96 (1•33-6•58)). The most recent meta-analysis 4 , having included 25 trials with nearly 2000 patients, showed quite similar results in terms of recurrences and prolapses.

Hence, the long-term results reported by Ganio et al. do not mean that SH and conventional haemorrhoidectomy are actually equivalent and do not definitively answer the question of the long-term efficacy of SH.

Whilst we wait for well-designed trials with adequate sample size and sufficient follow-up, the conclusions of the Cochrane review and the other metaanalyses suggesting significantly more haemorrhoidal prolapse and recurrence in the mid term (1-2 years) remain valid and are not questioned by the present study.