Xie Ya-Ting, Yuan Yu, Zhou Hui-Min, Liu Tao, Wu Li-Hao, He Xing-Xiang
Department of Gastroenterology, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou 510080, Guangdong Province, China.
World J Gastrointest Surg. 2022 Oct 27;14(10):1120-1130. doi: 10.4240/wjgs.v14.i10.1120.
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.
To assess long-term efficacy and safety of cap-assisted endoscopic sclerotherapy (CAES) with long injection needle for internal hemorrhoids.
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.
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.
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.
痔疮是一种常见的肛门疾病，可发生于任何年龄段的人群。中国的流行病学调查结果显示，肛肠疾病的患病率高达50.1%，其中98.08%的患者有痔疮症状。
评估使用长注射针的帽辅助内镜下硬化治疗（CAES）对内痔的长期疗效和安全性。
本研究为回顾性研究。收集了2016年4月至2019年12月期间使用内镜长注射针行CAES治疗的有症状内痔患者的数据。在2020年12月和2021年这两个时间点通过电话对患者进行随访，以评估症状改善情况、并发症、复发情况及满意度。
201例内痔患者接受了长针CAES治疗。首次中位随访在术后33个月进行。首次CAES治疗后87.5%的患者症状得到改善。疗效并未随治疗时间延长而降低。54例患者在首次CAES治疗后接受了结肠镜检查，其中21例再次接受了CAES治疗，4例接受了痔切除术。在首次随访时，62.7%的患者痔疮分级和症状均有改善，27.4%的患者在这两个参数上有显著改善。在第二次随访时，与术前值相比，61.7%的患者痔疮分级和症状有满意的改善。90%的患者报告CAES无痛，85%的患者对CAES治疗结果满意/非常满意。
本研究基于最大样本量报道了使用内镜长注射针行CAES治疗内痔的长期随访情况。我们的研究结果表明，CAES应是一种产生满意长期疗效和安全性的微创内镜技术。
