Multicenter analysis of the efficacy and factors related to recurrence of endoscopic sclerotherapy for internal hemorrhoids: a large-sample, retrospective cohort study.

Authors

Ying Zhu, Yingying Yang, Wen Xu, Xiaohua Bao

Published in

Surgical endoscopy. Aug 26, 2025. Epub Aug 26, 2025.

Abstract

Internal hemorrhoids are common, and while endoscopic sclerotherapy is emerging as a treatment, large-scale, multi-center data on its efficacy, safety, and recurrence rates are lacking. We summarized three-center large-sample endoscopic hemorrhoid sclerotherapy data, assess efficacy, complications, recurrence, and analyze recurrence factors (severity, lifestyle).
A retrospective analysis of patients with internal hemorrhoids treated with endoscopic sclerotherapy at three centers from December 2018 to December 2022 was conducted. Clinical and follow-up data were collected to assess hemorrhoid grading, treatment efficacy, complications, and recurrence rates. The recurrence rate, recurrence time, and related factors for different hemorrhoid grades were analyzed.
A total of 1147 patients underwent the procedure: 637 at Shenzhen Hospital of Southern Medical University, 177 at No. 964 Hospital, and 333 at Third Affiliated Hospital, Army Medical University. The overall effective rate was 92.85% (1065/1147). Postoperative safety measures showed the effective group had significantly lower pain (1 (0,1) vs. 2 (2,3)), bleeding (0 (0,1) vs. 2 (1,3)), and urination scores (0 (0,0) vs. 0 (0,1)) compared to the ineffective group. The overall recurrence rate was 12.21% (130/1065), with follow-up periods ranging from 3 to 49 months (mean: 25.61 ± 13.23 months). Recurrence time was earlier with increasing hemorrhoid grade (p < 0.05). Temporal analysis revealed that for Grades I, II, and III, recurrence rates within one year were 28, 39.78, and 75%, respectively, vs 72, 60.22, and 25% beyond 1 year. Multivariate logistic regression indicated higher BMI and lack of exercise were associated with increased recurrence (p < 0.05), while lower hemorrhoid grade, working position, and dietary habits were protective factors (p < 0.05).
Endoscopic sclerotherapy is a safe and effective treatment for internal hemorrhoids with a low short-term recurrence rate. Key factors influencing recurrence include BMI, exercise, hemorrhoid grade, working position, and dietary habits, providing insights for optimizing treatment strategies.

PMID:
40856750
Bibliographic data and abstract were imported from PubMed on 26 Aug 2025.

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