Laparoscopic rectal tumor surgery after administration of a new sclerosing therapy (aluminum potassium sulfate and tannic acid injection) for internal hemorrhoids: A report of three cases

Abstract Background Internal hemorrhoids are the most common anal diseases. Aluminum potassium sulfate and tannic acid (ALTA) injection is a new sclerosing therapy for the treatment of internal hemorrhoids. Although ALTA injection has been widely used, there are no previous reports of rectal cancer patients who underwent robot-assisted low anterior resection (Rob-LAR) after ALTA injection to treat internal hemorrhoids. Case presentation A 70-year-old man with rectal cancer was presented to our hospital. He had an ALTA injection 2 months before presentation at a clinic due to hematochezia with internal hemorrhoids. The rectal tumor was located 7 cm above the anal verge, and Rob-LAR with the da Vinci Xi system was performed. The patient had sclerosis on the stump of the anal side, which made it difficult to transect the rectum with linear staplers. This required multiple repeats of compression through the SmartClamp feedback. After anastomosis with the double-stapling technique, we constructed a diverting ileostomy. Conclusion Although ALTA injection is a promising strategy for internal hemorrhoids, rectal cancer should be excluded before the sclerosing therapy.

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Sclerosing Therapy with Aluminum Potassium Sulfate and Tannic Acid Injection for Anal Diseases: Experience of 1,000 Cases

Nippon Daicho Komonbyo Gakkai Zasshi ◽

10.3862/jcoloproctology.61.216 ◽

2008 ◽

Vol 61 (5) ◽

pp. 216-220 ◽

Cited By ~ 9

Author(s):

Y. Hachiro ◽

T. Abe ◽

M. Kunimoto

Keyword(s):

Tannic Acid ◽

Potassium Sulfate ◽

Acid Injection ◽

Sclerosing Therapy

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Gluteal-fold flap repair of rectovaginal fistula caused by aluminum potassium sulfate hydrate-tannic acid injection for internal hemorrhoids: a case report

Surgical Case Reports ◽

10.1186/s40792-020-00925-7 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Masanori Yoshimitsu ◽

Hiroyuki Egi ◽

Shogo Nagamatsu ◽

Manabu Shimomura ◽

Keishi Hakoda ◽

...

Keyword(s):

Case Report ◽

Tannic Acid ◽

Rectovaginal Fistula ◽

Potassium Sulfate ◽

Acid Injection ◽

Internal Hemorrhoids ◽

Flap Repair ◽

Sulfate Hydrate ◽

Gluteal Fold

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Successful treatment of painful internal hemorrhoids using aluminum potassium sulfate and tannic acid (ALTA) injection therapy in a terminal-stage patient

Palliative Care Research ◽

10.2512/jspm.7.562 ◽

2012 ◽

Vol 7 (2) ◽

pp. 562-567

Author(s):

Toru Ito ◽

Eizhi Inagi

Keyword(s):

Tannic Acid ◽

Successful Treatment ◽

Potassium Sulfate ◽

Injection Therapy ◽

Terminal Stage ◽

Internal Hemorrhoids

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Treatment of Internal Hemorrhoids by Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2015/517690 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 17

Author(s):

Yuichi Tomiki ◽

Seigo Ono ◽

Jun Aoki ◽

Rina Takahashi ◽

Shun Ishiyama ◽

...

Keyword(s):

Minimally Invasive ◽

Tannic Acid ◽

Internal Hemorrhoid ◽

Potassium Sulfate ◽

Endoscopic Sclerotherapy ◽

Normal Position ◽

Minimally Invasive Approach ◽

Invasive Approach ◽

Internal Hemorrhoids ◽

Mild Fever

Objective. A new sclerosing agent for hemorrhoids, aluminum potassium sulfate and tannic acid (ALTA), is attracting attention as a curative treatment for internal hemorrhoids without resection. The outcome and safety of ALTA sclerotherapy using an endoscope were investigated in the present study. Materials and Methods. Subjects comprised 83 internal hemorrhoid patients (61 males and 22 females). An endoscope was inserted and retroflexed in the rectum, and a 1st-step injection was applied to the upper parts of the hemorrhoids. The retroflexed scope was returned to the normal position, and 2nd–4th-step injections were applied to the middle and lower parts of the hemorrhoids under direct vision. The effects of endoscopic ALTA sclerotherapy were determined by evaluating the condition of the hemorrhoids using an anoscope and interviewing the patient 28 days after the treatment. Results. A cure, improvement, and failure were observed in 54 (65.1%), 27 (32.5%), and 2 (2.4%) patients, respectively, treated with ALTA. Complications developed in 4 patients (mild fever in 3 and hematuria in 1). Recurrence occurred in 9.6%. Conclusions. The results of the present study suggest that endoscopic ALTA has the potential to become a useful and minimally invasive approach for ALTA sclerotherapy.

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