Since 2005 when the aluminum potassium sulfate and tannic acid (ALTA) regimen was clinically introduced for internal hemorrhoids, it has become widespread from its simplicity and safety. However, few reports on the therapeutic outcome have been reported. We present therapeutic outcomes of ALTA regimen used in a total of 310 cases of internal hemorrhoids in our department. The mean observation duration was 32 (5 to 65) months. The mean operation time was 15 (4 to 27) minutes. The mean total injected volume of ALTA was 25 (6 to 40) mL. The mean injected dose of ALTA was 10 (6-15) mL per one injection. Complications were noted in 28 cases (9%), all of which were relieved conservatively. Recurrence was noted in 10 cases (3.2%). These recurrences appeared as re-prolapse of internal hemorrhoid in eight cases and as swelling of external hemorrhoid component in two cases. When recurrence cases were compared with non-recurrence cases, there were no satistically significant differences in age, sex, Goligher classification, operation time, number of hemorrhoids treated, and injected dose of ALTA. A study of recurrence cases disclosed that more recurrent lesions were present in the right anterior area ; and the recurrences appeared in a two-peak fashion, namely early recurrence within five months and late recurrence 17 months after the operation. Re-treatment with ALTA regimen was conducted for these recurrent cases.
The ALTA regimen is a therapy for benign disease internal hemorrhoid and can be applied for recurrent hemorrhoids. The ALTA regimen appears to be one of standard therapies for internal hemorrhoids in terms of its superior low invasiveness and safety.