Gravante G. Sclerotherapy for hemorrhoidal disease: Recent evolutions of an oldies goldy. World J Gastroenterol 2025; 31(8): 98704 [DOI: 10.3748/wjg.v31.i8.98704]
Corresponding Author of This Article
Gianpiero Gravante, MD, PhD, Department of General Surgery, Azienda Sanitaria Locale (ASL) Lecce, Ospedale “Francesco Ferrari”, Viale Francesco Ferrari 1, Casarano 73042, Lecce, Italy. ggravante@hotmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
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/
World J Gastroenterol. Feb 28, 2025; 31(8): 98704 Published online Feb 28, 2025. doi: 10.3748/wjg.v31.i8.98704
Sclerotherapy for hemorrhoidal disease: Recent evolutions of an oldies goldy
Gianpiero Gravante
Gianpiero Gravante, Department of General Surgery, Azienda Sanitaria Locale (ASL) Lecce, Casarano 73042, Lecce, Italy
Author contributions: Gravante G conceived, wrote and edited the article, and approved the final version.
Conflict-of-interest statement: The author reports no relevant conflicts of interest 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: Gianpiero Gravante, MD, PhD, Department of General Surgery, Azienda Sanitaria Locale (ASL) Lecce, Ospedale “Francesco Ferrari”, Viale Francesco Ferrari 1, Casarano 73042, Lecce, Italy. ggravante@hotmail.com
Received: July 3, 2024 Revised: December 19, 2024 Accepted: December 30, 2024 Published online: February 28, 2025 Processing time: 203 Days and 19.6 Hours
Abstract
Treatments for low degree hemorrhoids (I-III degree) are numerous and so are their counterparts for higher degrees. These treatments present nebulous differences in terms of indications and outcomes among techniques. Methods previously abandoned due to side effects and long-term results have recently rejoined the mainstream due to recent peculiar modifications: Hemorrhoidal sclerotherapy is enjoying a new age of interest due to the use of the foam form of polidocanol, which is more effective than the liquid one. Various articles have already shown promising results and the logical next step is the combination of polidocanol foam with rubber-band ligation (the historical counterpart of sclerotherapy) in a technique called “sclerobanding”. In this article, we comment on the publication by Qu et al further modifying the use of sclerobanding through an endoscopic delivery for patients with grade II-III internal hemorrhoids, and present results compared with endoscopic rubber band ligation. The results achieved are promising.
Core Tip: Sclerotherapy is living a new golden age due to the use of safer and more effective solutions. Polidocanol foam has achieved positive results even in peculiar settings such as bleeding patients or as a bridge treatment while waiting for definitive surgery. Endoscopic Polidocanol foam sclerobanding allows the precise application of banding and injection of the drug via direct visualization during endoscopy. Results are superior to rubber band ligation and the technique is a promising, practical, cost-effective approach for low-grades hemorrhoids.
