The effect of endoscopic polidocanol carbon dioxide foam for internal hemorrhoids: a retrospective study

This article aims to explore the effectiveness of polidocanol carbon dioxide foam as a therapy for internal hemorrhoids.

A retrospective analysis was conducted on 158 patients who received endoscopic polidocanol foam sclerotherapy for internal hemorrhoids between October 2022 and September 2023. Among the patients, 78 underwent endoscopic polidocanol sclerotherapy with polidocanol air foam (control group), while 80 received polidocanol carbon dioxide foam (study group). The primary outcomes of this study were clinical effect and the incidence of complications 1 month after surgery. Patient self-reports of anal bleeding and anal prolapse served as the foundation for establishing three categories of clinical efficacy criteria. The clinical effect was determined based on the efficacy index, which was employed to assess treatment effectiveness. The occurrence of several postoperative complications was documented, specifically including anal pain, anal swelling, urinary retention, perianal infection, ectopic embolization, and anal edema. Secondary outcomes encompassed the surgical cost, duration of hospital stay, and the administered dosage of polidocanol.

The treatment success at the end of the sclerotherapy session in the study and control group were 85.0% and 83.3%, respectively (P = 0.829). One month following endoscopic sclerotherapy, the study group exhibited an effective rate of 98.8%, while the control group showed a rate of 98.0%. Compared with the clinical effects one month after surgery of the two groups of patients, postoperative complications, surgical cost, hospitalization time and the dosage of polidocanol, we found 11 patients with anal pain and 12 patients with anal swelling in the control group. Within the study group, three patients experienced anal pain, while four patients presented with anal swelling. The study group exhibited significantly fewer patients with anal pain and anal swelling compared to the control group (P < 0.05), and importantly, no severe complications were observed. Both groups exhibited comparable clinical effects, surgical costs, hospitalization durations, and dosages of polidocanol, with no statistically significant differences observed (all P > 0.05).

The clinical effectiveness of endoscopic polidocanol carbon dioxide foam is on par with that of polidocanol air foam. In sclerotherapy for internal hemorrhoids, the use of endoscopic polidocanol carbon dioxide foam can significantly decrease complications such as anal swelling and pain.