Clinical Study Of Endoscopic Rubber Ring Ligation Combined With Foam Sclerosing Agent In The Treatment Of Internal Hemorrhoids Of Grade Ⅱ～Ⅲ Mixed Hemorrhoids

Objective: To investigate the clinical efficacy and safety of endoscopic rubber band ligation(ERBL)combined with endoscopic foam sclerotherapy(FS)in the treatment of internal hemorrhoids of grade Ⅱ～Ⅲ mixed hemorrhoids.Methods: Retrospective inclusion of 62 patients with mixed hemorrhoids treated in the Department of Gastroenterology and Gastrointestinal Surgery of Lianyungang Second People’s Hospital from September 2020 to May 2022.According to different surgical methods,30 patients who received ERBL combined with FS were included in the treatment group.32 patients who only underwent traditional surgical exfoliation and internal ligation were included in the control group.Compare and observe the clinical surgery time,hospitalization time,hospitalization expenses,postoperative complications,and clinical efficacy of two groups of patients.Follow up for 6 months to evaluate its clinical efficacy and safety.Results: Both groups of patients successfully completed the surgery.In terms of surgical time,hospitalization time,and hospitalization expenses,the treatment group was significantly less than the control group(P<0.05),and the difference was statistically significant;Six months after the operation,the patients in the treatment group had lower urinary retention,perianal redness,anal distention,and difficulty in defecation than those in the control group(P.The visual analog pain score(VAS)of the treatment group at 24 hours after surgery was 0(0,3),lower than the control group’s 2(0,4)score(Z=-3.777,P<0 001)。 The 1-week postoperative bleeding rate was 16.67%(5/30)in the treatment group and 71.88%(23/32)in the control group,both of which were mainly mild bleeding,with a statistically significant degree of bleeding(U=192.5,P<0.001).The total effective rates of the treatment group and the control group at 6 months after surgery were 96.67% and 81.25%,respectively.The treatment group was higher than the control group(P<0.05),and the difference was statistically significant;The postoperative recurrence rates of the treatment group and the control group were 3.33% and 18.75%,respectively.The treatment group was lower than the control group(P<0.05),and the difference was statistically significant.Conclusion: The combination of ERBL and FS under endoscopy is safe and effective in treating the internal hemorrhoids of grade II to III mixed hemorrhoids,significantly superior to traditional external dissection and internal ligation surgery,and has its unique technical advantages;For patients with mixed hemorrhoids of grade II to III,endoscopic ERBL combined with FS treatment has the advantages of shorter hospital stay,shorter surgical time,less postoperative pain,and lower incidence of other complications compared to traditional external dissection and internal ligation.The effect is significant,and the clinical application safety is high,making it easy for patients to accept.Endoscopic ERBL combined with FS for the treatment of mixed hemorrhoids of grade II to III with minimal damage and no postoperative scars.Follow up for 6 months showed good reduction and fixation of the anal pad,significant reduction or disappearance of hemorrhoids,and better minimally invasive treatment.