Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2024; 30(42): 4583-4586
Published online Nov 14, 2024. doi: 10.3748/wjg.v30.i42.4583
Endoscopic polidocanol foam sclerobanding for treatment of internal hemorrhoids: A novel outpatient procedure
An-Na Mou, Yu-Ting Wang
An-Na Mou, Yu-Ting Wang, Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, Sichuan Province, China
Author contributions: Mou AN wrote the manuscript; Wang YT revised and approved the final version.
Conflict-of-interest statement: We have nothing to disclose for this article.
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: Yu-Ting Wang, PhD, Professor, Department of Radiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, No. 32 Section 2, 1st Ring Road (West), Chengdu 610072, Sichuan Province, China. wangyuting_330@163.com
Received: July 23, 2024
Revised: September 14, 2024
Accepted: October 14, 2024
Published online: November 14, 2024
Processing time: 99 Days and 19.4 Hours
Abstract

In the study, we comment on the article by Qu et al. Internal hemorrhoids are the most common anorectal disorders worldwide with bleeding, prolapse, and difficulty in defecation. Endoscopic rubber band ligation (ERBL) is a safe, convenient, quick, and economical outpatient procedure. The main goal of ERBL is to alleviate prolapse, but the high incidence of recurrence and post-procedural pain are of clinical concern. Polidocanol foam as a local hemostatic and anesthetic agent could reduce the rates of post-procedural pain and bleeding. Endoscopic polidocanol foam sclerobanding (EFSB) is a novel approach that could lift the mucosa for easy ligation and promote increased scarring in the submucosal tissue which translates into long-term relief from prolapse recurrence and reduced 24-h post-procedural pain. The study by Qu et al is a novel multi-center prospective randomized study to compare ERBL and EFSB in patients with grades II and III internal hemorrhoids with one-year follow-up. Results showed that EFSB is a novel therapy for internal hemorrhoids, but future studies with a larger sample, multiple treatment sessions, and long-term follow-up are required to confirm these findings.

Keywords: Internal hemorrhoids; Goligher classification; Rubber band ligation; Sclerotherapy; Polidocanol foam

Core Tip: The clinical manifestations, pathogenesis, classification, and treatment in patients with internal hemorrhoids are briefly summarized. Endoscopic rubber band ligation (RBL) and injection sclerotherapy are widely used and recommended as a first-line outpatient procedure for hemorrhoids. In the prospective and multicenter study performed by Qu et al, endoscopic polidocanol foam sclerobanding, combining endoscopic polidocanol foam sclerotherapy with RBL, is evaluated in a clinical trial as a new procedure. It is a unique method to treat grade II and grade III internal hemorrhoids by reducing prolapse recurrence, reducing 24-h post-procedural pain, and improving long-term efficacy compared with endoscopic RBL.