Hypertrophic Anal Papillotomy by Transparent Cap-Assisted Endoscopic Hot Snare Resection

Abstract

Background/Aim: Conventional treatment for hypertrophic anal papillae (HAP) has effectiveness and safety concerns. This study aimed to investigate the feasibility, safety, and efficacy of transparent cap-assisted endoscopic hot snare resection for the treatment of HAP. Methods: Endoscopic and clinical data of patients treated with transparent cap-assisted endoscopic hot snare resection for HAP at the Department of Gastroenterology, First Affiliated Hospital of Yangtze University from June 2019 to June 2021, were collected and retrospectively analyzed. Results: A total of 56 patients with HAP were treated with transparent cap-assisted endoscopic hot snare resection, including 53 patients (94.6%) with single hypertrophic anal papillae and 3 patients (5.4%) with multiple HAP; 51 patients (83.6%) with basal diameter <5 mm and 10 patients (16.4%) with basal diameter ≥5 mm. The procedures that were performed together with transparent cap-assisted endoscopic hot snare resection for HAP treatment included total colon examination in 56 cases (100%), endoscopic polypectomy in 20 cases (35.7%), endoscopic sclerotherapy for hemorrhoids in 29 cases (51.8%), and endoscopic rubber band ligation for hemorrhoids in 11 cases (19.6%). No patient experienced bleeding during or after HAP with transparent cap-assisted endoscopic hot snare resection. Pain level was evaluated by the visual analog score (VAS) method. 52 patients (92.9%) did not have pain and 4 patients (7.1%) had mild pain 3 days after surgery. At a postoperative follow-up of 2 to 18 months, patient satisfaction with transparent cap-assisted endoscopic hot snare resection for HAP treatment was 100% (56/56). Conclusion: Transparent cap-assisted endoscopic hot snare resection is safe and effective for treating HAP.