{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T13:11:39Z","timestamp":1792674699392,"version":"4.5.0"},"reference-count":27,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,28]],"date-time":"2022-01-28T00:00:00Z","timestamp":1643328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Surgical treatment of hemorrhoidal disease (HD) in inflammatory bowel disease (IBD) has been considered to be potentially harmful, but the evidence for this is poor. Therefore, a systematic review of the literature was undertaken to reappraise the safety and effectiveness of surgical treatments in this special circumstance. A MEDLINE, Web of Science, Scopus, and Cochrane Library search was performed to retrieve studies reporting the outcomes of surgical treatment of HD in patients with Crohn\u2019s disease (CD) and ulcerative colitis (UC). From a total of 2072 citations, 10 retrospective studies including 222 (range, 2\u201370) patients were identified. Of these, 119 (54%) had CD and 103 (46%) UC. Mean age was between 41 and 49 years (range 14\u201377). Most studies lacked information on the interval between surgery and the onset of complications. Operative treatments included open or closed hemorrhoidectomy (n = 156 patients (70%)), rubber band ligation (n = 39 (18%)), excision or incision of thrombosed hemorrhoid (n = 14 (6%)), and doppler-guided hemorrhoidal artery ligation (DG-HAL, n = 13 (6%)). In total, 23 patients developed a complication (pooled prevalence, 9%; (95%CI, 3\u201316%)), with a more than two-fold higher rate in patients with CD compared to UC (11% (5\u201316%) vs. 5% (0\u201313%), respectively). Despite the low quality evidence, surgical management of HD in IBD and particularly in CD patients who have failed nonoperative therapy should still be performed with caution and limited to inactive disease. Further studies should determine whether advantages in terms of safety and effectiveness with the use of non-excisional techniques (e.g., DG-HAL) can be obtained in this patient population.<\/jats:p>","DOI":"10.3390\/jcm11030709","type":"journal-article","created":{"date-parts":[[2022,1,29]],"date-time":"2022-01-29T05:26:17Z","timestamp":1643433977000},"page":"709","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Surgical Management of Hemorrhoidal Disease in Inflammatory Bowel Disease: A Systematic Review with Proportional Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-2873","authenticated-orcid":false,"given":"Ugo","family":"Grossi","sequence":"first","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1066-4671","authenticated-orcid":false,"given":"Gaetano","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, 53100 Siena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5470-3567","authenticated-orcid":false,"given":"Gian Luca","family":"Di Tanna","sequence":"additional","affiliation":[{"name":"Statistics Division, The George Institute for Global Health, University of New South Wales, Sydney 2042, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Bracale","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u2018Federico II\u2019 University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Ballo","sequence":"additional","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Galasso","sequence":"additional","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Kazemi Nava","sequence":"additional","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martino","family":"Zucchella","sequence":"additional","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cinetto","sequence":"additional","affiliation":[{"name":"Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Rattazzi","sequence":"additional","affiliation":[{"name":"Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Felice","sequence":"additional","affiliation":[{"name":"Department of Medicine-DIMED, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5489-3009","authenticated-orcid":false,"given":"Giacomo","family":"Zanus","sequence":"additional","affiliation":[{"name":"II Surgery Unit, Regional Hospital Treviso, AULSS2, 31100 Treviso, Italy"},{"name":"Department of Surgery, Oncology and Gastroenterology-DISCOG, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1007\/s00384-017-2833-5","article-title":"Protocol for the development of a Core Outcome Set (COS) for hemorrhoidal disease: An international Delphi study","volume":"32","author":"Melenhorst","year":"2017","journal-title":"Int. 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