Redefining hemorrhoid therapy with endoscopic polidocanol foam sclerobanding

Abstract

Hemorrhoids are a common and painful condition, with conventional treatments such as endoscopic rubber band ligation (ERBL) and injection sclerotherapy often falling short due to high recurrence rates and significant post-operative pain. A clinical trial by Qu et al introduces a novel approach called endoscopic poli-docanol foam sclerobanding (EFSB). This multicenter randomized trial involved 195 patients with grade II and III internal hemorrhoids and demonstrated that EFSB significantly reduced recurrence rates and post-procedural pain while improving symptom relief and patient satisfaction compared to ERBL. The study's strengths include its robust design, comprehensive outcome evaluation, and patient-centered approach. Despite limitations such as the single-blind design and relatively short follow-up period, the findings suggest that EFSB could enhance clinical practice by offering a more effective and patient-friendly treatment option. Further research is needed to validate these results and explore the long-term benefits and cost-effectiveness of EFSB.

Keywords: Hemorrhoids; Endoscopic polidocanol foam sclerobanding; Rubber band ligation; Injection sclerotherapy; Hemorrhoids recurrence; Post-operative pain

Core Tip: This editorial highlights the groundbreaking study by Qu et al, which reveals that endoscopic polidocanol foam sclerobanding effectively reduces recurrence and post-procedural pain in grade II and III internal hemorrhoids compared to the traditional endoscopic rubber band ligation. Despite multiple limitations, such as a shorter follow-up period and potential subjective bias, the trial reflects profound clinical implications while suggesting additional research and innovative approaches to treatment.