Use of Flavonoids for the treatment of symptoms after hemorrhoidectomy with radiofrequency scalpel

OBJECTIVES: Control of postoperative symptoms is of paramount importance in proctologic surgery. Phlebotropic activity, protective effect on the capillaries and anti-inflammatory properties of the flavonoids have been reported in several studies. They have been used to treat a variety of conditions including chronic venous insufficiency, lymphedema and hemorrhoids. Numerous trials, assessing the effect of phlebotonics in treating the symptoms and signs of haemorrhoidal disease, suggest that there is a potential benefit. Our trial was conducted to evaluate whether the flavonoids reduce postoperative bleeding, pain and other symptoms after hemorrhoidectomy. PATIENTS AND METHODS: We compared the results obtained in 24 patients undergoing open hemorrhoidectomy with radiofrequency scalpel. Our study cohort was randomized in two groups: the Group A received flavonoids in the postoperative period, the Group B has constituted the control group, without administration of study drug. Follow-up outpatient visits were performed on 7, 15 and 30 postoperative day (POD). During the visits the patients expressed trough a list of specific questions, based on a scoring system (1 to 10), their opinion about the extent of postoperative symptoms as pain, bleeding, tenesmus, pruritus and perianal weight. RESULTS: We observed that the results obtained after 7 days of surgery are similar in both study groups. Even after 15 and 30 days no significant changes were observed between the two groups about pain and bleeding. Instead, we observed significant differences regarding tenesmus (group A: 8.0 +/- 1.1 vs Group B: 5.4 +/- 1.5 at 15 POD, p < 0.05; group A: 9.1 +/- 0.8 vs Group B: 5.7 +/- 0.9 at 30 POD, p < 0.05), pruritus (group A: 7.1 +/- 1.4 vs Group B: 4.8 +/- 1 at 15 POD, p < 0.05; group A: 9.5 +/- 0.5 vs Group B: 6.6 +/- 0.8 at 30 POD, p < 0.05) and perianal weight (group A: 7.2 +/- 0.9 vs Group B: 6.2 +/- 0.8 at 15 POD, p < 0.05; group A: 9.75 +/- 0.4 vs Group B: 7.3 +/- 0.9 at 30 POD, p < 0.05). CONCLUSIONS: Our results confirm the usefulness of this drug to reduce the prevalence and the importance of post-hemorrhoidectomy symptoms and make more comfortable the postoperative period