Evaluation of the Effectiveness of Micronized Purified Flavonoid Fraction (MPFF) in Patients With Haemorrhoids Undergoing Minimally Invasive Surgical Interventions

This observational program does not imply changes to the common treatment strategy in patients with chronic hemorrhoids. In this observational study, the parameters usually assessed during the examination of patients with grade 2 or 3 chronic hemorrhoids, according to the Goligher classification, will be recorded The observational design of the program assumes that all examinations, procedures and changes to the patient's therapy, including changes in the doses of medications, should be carried out only per decision of the attending physician and in full accordance with existing guidelines for the management of patients of the analysed category, instructions for the medical use of a medicinal product and within the established routine practice.

Primary outcomes

• The pain syndrome severity score (spontaneous pain) of the visual analog scale (VAS) [7 days]: The change in the pain syndrome severity score (spontaneous pain) of the visual analog scale (VAS) on day 7 after the intervention as compared with the baseline value at the V0 visit. visual analogue scale (VAS). a 100 mm long scale, in which the 0 mm point corresponds to the absence of pain (minimum value) and the 100 mm point to maximum, unbearable pain (maximum values)

Secondary outcomes

• Pain syndrome - Spontaneous pain(1) [14 days]: The change in the pain syndrome severity score (spontaneous pain) of VAS on day 14 after the intervention as compared with the baseline value at the V0 visit. visual analogue scale (VAS). a 100 mm long scale, in which the 0 mm point corresponds to the absence of pain (minimum value) and the 100 mm point to maximum, unbearable pain (maximum values)
• Pain syndrome - Spontaneous pain (2) [25 days]: The change in the pain syndrome severity score (spontaneous pain) of VAS on day 25 after the intervention as compared with the baseline value at the V0 visit. visual analogue scale (VAS). a 100 mm long scale, in which the 0 mm point corresponds to the absence of pain (minimum value) and the 100 mm point to maximum, unbearable pain (maximum values)
• Use of analgesics [7 days]: The proportion (%) of patients continuing to take analgesics on days 7 after the intervention as compared with the baseline value at the V0 visit.
• Use of analgesics [14 days]: The proportion (%) of patients continuing to take analgesics on days 14 after the intervention as compared with the baseline value at the V0 visit.
• Use of analgesics [25 days]: The proportion (%) of patients continuing to take analgesics on days 25 after the intervention as compared with the baseline value at the V0 visit.
• Bleeding (1) [7 days]: Change in the score of bleeding (frequency, intensity) on the 4-point Likert scale on day 7 day after the intervention as compared with the baseline value at the V0 visit.
• Bleeding (2) [14 days]: Change in the score of bleeding (frequency, intensity) on the 4-point Likert scale on day 14 day after the intervention as compared with the baseline value at the V0 visit.
• Bleeding (3) [25 days]: Change in the score of bleeding (frequency, intensity) on the 4-point Likert scale on day 25 day after the intervention as compared with the baseline value at the V0 visit.
• Perianal edema (1) [7 days]: Change in the perianal edema score of the 4-point Likert scale (by the objective examination data) on day 7 day after the intervention as compared with the baseline value at the V0 visit.
• Perianal edema (2) [14 days]: Change in the perianal edema score of the 4-point Likert scale (by the objective examination data) on day 14 day after the intervention as compared with the baseline value at the V0 visit.
• Perianal edema (3) [25 days]: Change in the perianal edema score of the 4-point Likert scale (by the objective examination data) on day 25 day after the intervention as compared with the baseline value at the V0 visit.
• Pain syndrome - Pain related to defecation (1) [7 days]: The change in the pain syndrome severity score (pain related to defecation) of VAS on day 7 after the intervention as compared with the baseline value at the V0 visit.
• Pain syndrome - Pain related to defecation (2) [14 days]: The change in the pain syndrome severity score (pain related to defecation) of VAS on day 14 after the intervention as compared with the baseline value at the V0 visit.
• Pain syndrome - Pain related to defecation (3) [25 days]: The change in the pain syndrome severity score (pain related to defecation) of VAS on day 25 after the intervention as compared with the baseline score at the V0 visit.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Males and females aged over 18 years.
* Informing the patient in writing about the inclusion in the study and his/her consent to participate in it.
* Absence of conditions requiring urgent medical care.
* The patient was diagnosed with chronic hemorrhoids of grade 2 or 3 according to Goligher classification.
* The patient is scheduled to undergo one of the listed types of minimally invasive surgical treatment within 7 ± 2 days from the inclusion in the study (V0):
* laser vaporization (laser submucosal destruction or ablation);
* transanal dearterialization (hemorrhoidal artery ligation);
* transanal dearterialization + laser vaporization (laser submucosal destruction or ablation);
* transanal dearterialization + sclerotherapy.
* No venoactive drug treatment within 4 weeks prior to inclusion in the study.
* The patient has been prescribed with MPFF at the inclusion visit, or it is planned to prescribe MPFF-containing drug in the postoperative period (for cluster 1 sites), or the patient has not been prescribed with any systemic venoactive drug, and it is not planned to prescribe it the postoperative period (for cluster 2 sites).*

Exclusion Criteria:

* Pregnancy or breast-feeding, or planning for pregnancy during the study or at least in two months after its completion.
* Confirmed or suspected malignancy.
* Severe somatic disorder (of heart or blood vessels, lungs, kidneys, pancreas, or liver), accompanied by the organ function decompensation.
* Mental disorder.
* Contraindications for examination.
* Predicted unwillingness of the patient to follow the protocol of treatment and supervision, poor adherence to treatment.
* Patient's participation in any interventional/observational study at the present time.
* Patients who received venoactive drugs in the 4 weeks prior to Visit 0 (inclusion visit).

• Ivan KOSTAREV, Principal investigator, A.N. Ryzhikh National Medical Research Center of Proctology