Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2022; 14(10): 1120-1130
Published online Oct 27, 2022. doi: 10.4240/wjgs.v14.i10.1120
Long-term efficacy and safety of cap-assisted endoscopic sclerotherapy with long injection needle for internal hemorrhoids
Ya-Ting Xie, Yu Yuan, Hui-Min Zhou, Tao Liu, Li-Hao Wu, Xing-Xiang He
Ya-Ting Xie, Yu Yuan, Hui-Min Zhou, Tao Liu, Li-Hao Wu, Xing-Xiang He, Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, Guangdong Province, China
Author contributions: He XX, Yuan Y and Xie YT designed the concept of the study; Zhou HM, Wu LH and Liu T collected and analyzed the data; Xie YT and Yuan Y wrote the draft manuscript; all authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.
Institutional review board statement: The study was reviewed and approved by the the First Affiliated Hospital of Guangdong Pharmaceutical University Institutional Review Board (No.2016-(33)-01).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at hexingxiang@gdpu.edu.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xing-Xiang He, MD, Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, No. 19 Lower Nonglin Street, Yuexiu District, Guangzhou 510080, Guangdong Province, China. hexingxiang@gdpu.edu.cn
Received: June 24, 2022
Peer-review started: June 24, 2022
First decision: August 1, 2022
Revised: August 19, 2022
Accepted: September 22, 2022
Article in press: September 22, 2022
Published online: October 27, 2022
Processing time: 122 Days and 22.6 Hours
Abstract
BACKGROUND

Hemorrhoids are a common anal condition and can afflict an individual at any age. Epidemiological survey results in China show that the prevalence of anorectal diseases is as high as 50.1% among which 98.08% of patients have hemorrhoid symptoms.

AIM

To assess long-term efficacy and safety of cap-assisted endoscopic sclerotherapy (CAES) with long injection needle for internal hemorrhoids.

METHODS

This study was retrospective. Data from patients with symptomatic internal hemorrhoids treated with CAES using endoscopic long injection needle from April 2016 to December 2019 were collected. Patients were telephoned and followed at two time points, December 2020 and 2021, to evaluate the improvements in symptoms, complications, recurrence, and satisfaction.

RESULTS

Two hundreds and one patients with internal hemorrhoids underwent CAES with the long needle. The first median follow-up was performed 33 mo post-operatively. Symptoms improved in 87.5% of patients after the first CAES. Efficacy did not decrease with treatment time extension. Fifty-four patients underwent colonoscopy after the first CAES treatment of which 21 underwent CAES again, and 4 underwent hemorrhoidectomy. At the first follow-up, 62.7% of patients had both improved hemorrhoid grades and symptoms, and 27.4% had a significant improvement in both parameters. At the second follow-up, 61.7% of the patients showed satisfactory improvement in their hemorrhoid grade and symptoms when compared with pre-surgery values. 90% of patients reported CAES was painless, and 85% were satisfied/very satisfied with CAES treatment outcomes.

CONCLUSION

The present study based on the largest sample size reported the long-term follow-up of the treatment for internal hemorrhoid with the CAES using endoscopic long injection needle. Our findings demonstrate that CAES should be a micro-invasive endoscopic technology yields satisfactory long-term efficacy and safety.

Keywords: Hemorrhoids; Cap-assisted endoscopic sclerotherapy; Long injection needle; Efficacy; Prolapse

Core Tip: Cap-assisted endoscopic sclerotherapy (CAES) is a novel procedure to process flexible endoscopic sclerotherapy. Data from patients with symptomatic internal hemorrhoids treated with CAES using endoscopic long injection needle from April 2016 to December 2019 were collected. Patients were telephoned and followed at two time points, December 2020 and 2021, to evaluate the improvements in symptoms, complications, recurrence, and satisfaction. The present study based on the largest sample size reported the long-term follow-up of the treatment for internal hemorrhoid with the CAES using endoscopic long injection needle. Our findings demonstrate that CAES should be a micro-invasive endoscopic technology yields satisfactory long-term efficacy and safety.