Cap-assisted endoscopic sclerotherapy for hemorrhoids: a prospective study (with video)

Abstract

Objective To evaluate the methodology, feasibility, safety and efficacy of cap-assisted endoscopic sclerotherapy (CAES) for hemorrhoids. Methods Patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES from September 2014 to May 2016. According to the methodology of CAES, reasons for blooding were identified and polypectomy and excision of anal papilla fibroma was performed. Efficacy, intraoperative and postoperative complications and patient satisfaction were evaluated during and after CAES. The follow-up was more than three months. Results A total of 48 patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES, including 25(52.1%) patients with grade Ⅰ, 21(43.8%) patients with grade Ⅱ, and 2(4.2%) grade Ⅲ. During the whole procedure of CAES, colon and terminal ileum examination was performed in 48(100.0%) patients, polypectomy was performed in 14(29.2%) patients, excision of anal papilla fibroma was performed in 1(2.1%) patient, excision of external hemorrhoids was performed in 1(2.1%) patient, biopsy for the polyps on dentate line was performed in 2(4.2%) patients, and sclerotherapy for rectal mucosal prolapse was performed in 2(4.2%) patients. No bleeding was observed during and after CAES. Infection occurred in one (2.1%) patient, who recovered with a one-week anti-infective therapy. One (2.1%) patient claimed mild tenesmus within four days after CAES. No complications were observed within the three-month follow-up. All patients (100.0%) were satisfied with this novel procedure. Conclusion CAES, as a novel endoscopic sclerotherapy, is a safe and effective endoscopic therapy with high patient satisfaction for internal hemorrhoids. Key words: Hemorrhoids; Cap-assisted endoscopic sclerotherapy; Colonoscopy