3.1 To inform the committee, NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 4 sources, which was discussed by the committee. The evidence included 4 case series, and is presented in table 2 of the interventional procedures overview. Other relevant literature is in the appendix of the overview.
3.2 The specialist advisers and the committee considered the key efficacy outcomes to be: quality of life, symptom improvement and stopping bleeding.
3.3 The specialist advisers and the committee considered the key safety outcomes to be: bleeding, rectal ulceration and colonic ischaemia.
3.4 Patient commentary was sought but none was received.
3.5 This guidance does not apply to the emergency treatment of patients presenting with acute rectal bleeding.
3.6 The committee was informed that this procedure may be useful when other treatments for haemorrhoids are contraindicated, such as in patients with coagulation disorders.
3.7 The committee noted that although this is a common condition there is a lack of published evidence on patient selection for this procedure, and it felt that further information on this would be helpful.