EP231 - A Short-Term Follow-Up Report on a Randomized Controlled Study of Open Excisional Hemorrhoidectomy Combined with Sclerotherapy with 3% Polidocanol Foam

Sunday, May 11, 2025

8:10 AM – 8:15 AM PT

Location: Monitor 3, Sails Pavilion, Upper Level

ePoster Presenter(s)

Xiangyi Yin, Master's Degree

Resident doctor
Department of Anorectal Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

GG

Gaetano Gallo, n/a

Assistant Professor
Department of Surgery, Sapienza University of Rome
Roma, Lazio, Italy

Disclosure information not submitted.
Jiaqi Jiang

Physician in Charge
Department of Anorectal Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
YL

Yuchang Lu, Master's Degree

Resident doctor
Department of Anorectal Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.
BL

Biao Liang, n/a

resident physician
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.
JN

Jiachun Ni, n/a

resident doctor；PhD
Department of Anorectal Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

Disclosure information not submitted.

Senior Author(s)

Zhenyi Wang, MD,PHD (he/him/his)

Director of Anorectal Medicine Department
Department of Anorectal Surgery, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
Shanghai, Shanghai, China (People's Republic)

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Xiangyi Yin, Master's Degree: This individual has no financial relationships with ineligible companies.

Jiaqi Jiang: This individual has no financial relationships with ineligible companies.

Zhenyi Wang, n/a: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Sclerotherapy has demonstrated good efficacy in treating Grade I-II internal hemorrhoids, particularly when bleeding is the main symptom. However, its effectiveness diminishes for Grade IV internal hemorrhoids, mixed hemorrhoids. In patients with a larger number of hemorrhoidal piles, the surgeon must consider minimizing mucocutaneous bridges damage during open excisional hemorrhoidectomy to prevent the risk of anal canal stenosis and postoperative bleeding.Currently, our center is conducting an open-label, randomized controlled clinical trial to evaluate the surgical treatment effect of open excisional hemorrhoidectomy combined with Sclerotherapy with 3% Polidocanol Foam on the the residual piles.The purpose of this report is to summarize and analyze the rapid results of the trial within one month.

Methods/Interventions: A total of 36 patients were enrolled between August and September 2024, and were randomly assigned to two groups: the experimental group (n=18) and the control group (n=18). The experimental group underwent open excisional hemorrhoidectomy combined with 3% polidocanol foam sclerotherapy in the residual piles with mucocutaneous bridges function. above the dentate line, while the control group received only open excisional hemorrhoidectomy. Continuous follow-up was conducted over the course of one month post-surgery to gather data on the time required for patients to resume daily activities (including work), Hemorrhoidal Disease Symptom Score (HDSS), Short Health Scale for hemorrhoids (SHS-HD), analgesic use frequency, and Postoperative Bleeding Score.

Results/Outcomes: The primary efficacy results show that the experimental group has a significantly shorter average recovery time for resuming daily activities (19.28±8.35 days) compared to the control group (25.06±7.85 days), with a statistically significant difference (p=0.04). A total of eight patients (22%, 8/36) return to work within 14 days post-surgery, with 87.5% of them (7/8) in the experimental group and only one from the control group. There is a significant difference in the total HDSS score between the two groups one month after surgery (p=0.012), with a median score of 8 in the experimental group and 11 in the control group. Analysis of the subcategories in the patient questionnaires reveals significant differences between the groups in the frequency of pain episodes and bleeding (p=0.016, p=0.010). Postoperative bleeding score, and analgesic use are all notably lower in the experimental group compared to the control group (p < 0.05). The median SHS-HD score is 12 in the experimental group and 14 in the control group, but this difference is not statistically significant. One patient from the control group experiences significant bleeding on postoperative day five and requires local anesthesia with suturing to control the bleeding.

Conclusion/Discussion: This study find that the short-term outcomes of this combined procedure are favorable, based on various postoperative indicators. It can reduce postoperative bleeding, decrease the need for analgesics, and help patients return to work and social activities more quickly. The research is still ongoing, but its clinical application value is already becoming apparent and is worth exploring.