Wang Xianglu, Wu Xia, Wen Quan, Cui Bota, Zhang Faming
Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
Key Lab of Holistic Integrative Enterology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
J Clin Med. 2024 Nov 29;13(23):7284. doi: 10.3390/jcm13237284.
Hemorrhoidal disease (HD) is a prevalent proctological condition that has puzzled people since ancient times, and the most common symptom is painless bleeding. Traditional treatments include conservative treatment, nonsurgical office-based treatments, and surgery. Sclerotherapy is one of the oldest forms of nonoperative intervention and is widely used to treat internal hemorrhoids with the development of endoscopy technology. However, sclerotherapy is always accompanied by complications such as bleeding, pain, abscess, etc., when the sclerosant is injected into the wrong site. Cap-assisted endoscopic sclerotherapy (CAES), a new minimally invasive technology, was first time coined in 2015 for the treatment of hemorrhoidal disease. The left-posterior-right-anterior (LPRA) anus positioning method under endoscopy provides reliable methodological support for advancing hemorrhoidal treatment via endoscopy. The current trend is that treatment for HD has shifted from being performed predominantly by the Department of Proctology Surgery to being managed mostly by the Department of Gastroenterology. This review reviewed the shifting paradigms of sclerotherapy for HD and discussed the emerging development of CAES.
痔病（HD）是一种常见的直肠疾病，自古以来就困扰着人们，最常见的症状是无痛性出血。传统治疗方法包括保守治疗、非手术门诊治疗和手术治疗。硬化疗法是最古老的非手术干预形式之一，随着内镜技术的发展，被广泛用于治疗内痔。然而，当硬化剂注射到错误部位时，硬化疗法总是伴随着出血、疼痛、脓肿等并发症。帽辅助内镜硬化疗法（CAES）是2015年首次提出的一种新的微创技术，用于治疗痔病。内镜下左后右前（LPRA）肛门定位方法为通过内镜推进痔病治疗提供了可靠的方法学支持。目前的趋势是，痔病的治疗已从主要由直肠外科进行转变为大多由胃肠病科管理。本文综述了痔病硬化疗法的转变模式，并讨论了CAES的新发展。
