Wu SY, Chen YS, Li XH, Yu TJ, Xie F, Jiang QF, Lan Y, He P, Li SC, Li WS, Chen WD. Efficacy and safety of endoscopic sclerotherapy vs traditional surgery in the treatment of internal hemorrhoids: A meta-analysis. World J Gastrointest Endosc 2026; 18(3): 116697 [DOI: 10.4253/wjge.v18.i3.116697]
Corresponding Author of This Article
Wei-Dong Chen, MD, Chief Physician, Department of Anorectal Surgery, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Hongxing Street, Luzhou 646000, Sichuan Province, China. nxcz-2003@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 16, 2026 (publication date) through Mar 18, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Endoscopy
ISSN
1948-5190
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Wu SY, Chen YS, Li XH, Yu TJ, Xie F, Jiang QF, Lan Y, He P, Li SC, Li WS, Chen WD. Efficacy and safety of endoscopic sclerotherapy vs traditional surgery in the treatment of internal hemorrhoids: A meta-analysis. World J Gastrointest Endosc 2026; 18(3): 116697 [DOI: 10.4253/wjge.v18.i3.116697]
Si-Yi Wu, Ying-Shuang Chen, Xian-Hang Li, Teng-Jiang Yu, Fei Xie, Qing-Feng Jiang, Yong Lan, Ping He, Shi-Chao Li, Wu-Sheng Li, Wei-Dong Chen, Department of Anorectal Surgery, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, Sichuan Province, China
Shi-Chao Li, Wu-Sheng Li, Wei-Dong Chen, The Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Digestive System Diseases, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou 646000, Sichuan Province, China
Co-first authors: Si-Yi Wu and Ying-Shuang Chen.
Co-corresponding authors: Wu-Sheng Li and Wei-Dong Chen.
Author contributions: Li SC and Chen WD conceived and designed the study; Yu TJ, Xie F, Jiang QF and Lan Y searched the literature, extracted the data and performed the statistical analysis; Chen YS, Li SC, Wu SY and Li XH drafted the manuscript; He P, Li WS and Chen WD critically revised and gave final approval of the manuscript; Wu SY and Chen YS have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Li WS and Chen WD have played important and indispensable roles in the experimental design, data interpretation and manuscript preparation as the co-corresponding authors.
Supported by Scientific Research Program of Sichuan Provincial Administration of Traditional Chinese Medicine, No. 2021MS360; and the Scientific Research Program of the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University, No. 2020XYLH-039.
Conflict-of-interest statement: The authors declare no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Wei-Dong Chen, MD, Chief Physician, Department of Anorectal Surgery, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Hongxing Street, Luzhou 646000, Sichuan Province, China. nxcz-2003@163.com
Received: November 18, 2025 Revised: December 6, 2025 Accepted: January 20, 2026 Published online: March 16, 2026 Processing time: 115 Days and 13.2 Hours
Abstract
BACKGROUND
Internal hemorrhoids are among the most common colorectal diseases worldwide. Although traditional surgeries (TS) are widely used, postoperative complications or discomfort may occur to varying degrees. In recent years, endoscopic sclerotherapy (ES) has gradually emerged as a minimally invasive alternative; however, its overall clinical value compared with that of TS has not yet been clearly confirmed.
AIM
To evaluate the impact of ES in comparison to TS on internal hemorrhoid outcomes.
METHODS
A comprehensive search was conducted across several databases, including the PubMed, EMBASE, Cochrane Library, Clinical trials.gov, China National Knowledge Infrastructure, Wanfang, and VIP databases. This search aimed to identify randomized controlled trials (RCTs) that compared ES with TS in patients who underwent internal hemorrhoid surgery. The primary outcome assessed was clinical efficacy, whereas the secondary outcomes included complications and other essential clinical metrics. A total of 17 RCTs involving 1689 patients were included in the meta-analysis.
RESULTS
The results of the pooled analysis indicated that, compared with TS, ES exhibited superior clinical efficacy. Furthermore, ES had a minimal effect on work resumption and demonstrated superior efficacy in controlling bleeding and reducing hemorrhoid prolapse in comparison to TS. Compared with TS, ES significantly reduced the incidence of postoperative complications, including bleeding, anal bulge, anal edema, urinary retention, and infection. Additionally, ES was associated with lower treatment costs, shorter hospitalization durations, shorter healing times, shorter operation times, and less blood loss. In patients with internal hemorrhoids, compared with TS, ES resulted in faster recovery, a lower risk of complications and superior efficacy.
CONCLUSION
Therefore, ES is a safe and effective surgical method for the treatment of internal hemorrhoids.
Core Tip: This is the first meta-analysis to compare endoscopic sclerotherapy (ES) with traditional surgery for the treatment of internal hemorrhoids. ES provided higher efficacy, fewer complications and lower costs, offering a minimally invasive alternative for grade I-III hemorrhoids.
