Table 2.
Objective hemorrhoidal disease classification.
Classification | Advantage | Disadvantage | Treatment relevance | Reproducibility | Practicality | Assessment value |
---|---|---|---|---|---|---|
Miles | Associated with treatment modality | Lack of evidence-based medical evidence; lack of classification of internal and external hemorrhoids | ✰ | ⋆ | ✰⋆ | |
Goligher classification | Wide range of application | Lack of bleeding and classification of internal and external hemorrhoids; not associated with treatment modality; lack of evidence-based medical evidence | ⋆ | ⋆ | ||
Histoclinical basis | Novel; consideration of complications | Lack of classification of internal and external hemorrhoids; not associated with treatment modality; lack of evidence-based medical evidence | ⋆ | ⋆ | ||
Lunniss classification | Comprehensive; refine the classification of non-prolapsed hemorrhoids | Complicated; lack of evidence-based medical evidence | ⋆ | ⋆ | ||
SPC | Novel; focusing on the single piles; describe the anatomy in detail | Not associated with treatment modality | ⋆ | ⋆ | ⋆⋆ | |
India hemorrhoid classification | Subdivide of the number, circumference and thrombosed hemorrhoids | Lack of bleeding and classification of internal and external hemorrhoids; lack of evidence-based medical evidence | ⋆ | ⋆ | ⋆⋆ | |
A/CTC | Quantifying prolapse; concern about complications and contraindications to treatment modalities | Complicated | ⋆ | ⋆ | ⋆⋆ | |
BPRST | Novel; comprehensive | Complicated; ambiguous treatment modalities | ⋆ | ⋆ | ⋆⋆ | |
Japanese colonoscope classification | More objective assessment of bleeding | Not for general use; rated by the guide rated as non-standard; not associated with treatment modality | ⋆ | ⋆ | ||
Colonoscopic classification of internal hemorrhoids | Reduces observer variability | Not for general use; not associated with treatment modality | ⋆ | ⋆ | ||
Videoanoscopy | Wide view; high sensitivity; unexplained gastrointestinal bleeding can be ruled out | Not for general use; not associated with treatment modality | ⋆ | ✰ | ⋆✰ | |
Fabio Gaj classification | Classification according to the number of hemorrhoids and complications | Not associated with treatment modality | ⋆ | ⋆ | ⋆⋆ |
If the hemorrhoidal disease classification fully satisfies the corresponding necessary factors ⋆; if the hemorrhoidal disease classification partially satisfies the corresponding necessary factors ✰; if the hemorrhoidal disease classification does not satisfy the corresponding necessary factors, no indication is given. SPC, The Single Pile Classification; A/CTC, Anatomical/Clinical-Therapcutic Classification; BPRST, Bleeding;Prolapse; Reduction; Skin tag; Thrombosis.