Abstract:

Objective

To explore the clinical application value of different needle extension lengths in cap-assisted endoscopic sclerotherapy for third-degree internal hemorrhoids.

Methods

The clinical data of 120 patients with third-degree internal hemorrhoids，admitted to Baotou Central Hospital Inner Mongolia from January 2019 to December 2022，were collected and randomly divided into three groups，with 40 cases in each group.Group A underwent sclerotherapy with needle extension length of 9 mm，Group B underwent sclerotherapy with needle extension length of 4 mm，and Group C underwent traditional surgical treatment.The differences in operation time，surgical cost，hospital stay，clinical efficacy，and complication rates were compared among the groups.

Results

The improvement rates of internal hemorrhoid prolapse and internal hemorrhoid hematochezia in Group A+B were 85%，91.25%，compared to 90%，97.5% in Group C，both with no significant differences （P＞0.05）.The complication rates in Group A+B was 8.75%，which was obviously lower than that in Group C（25%） ，and the differences was statistically significant （P＜0.05）.In subgroup analysis，Group A and Group B were both superior to Group C in terms of operation time，hospital stay，surgical cost，however，there were all no significant statistical difference between Group A and Group B.In terms of the improvement rate of internal hemorrhoid prolapse，Group A was significantly better than Group B（95% vs. 75%）.While，there was no significant statistical difference between Group A and Group B in internal hemorrhoid hematochezia （95% vs. 87.5%）.

Conclusion

Endoscopic sclerotherapy is effective for the management of third-degree internal hemorrhoids，with a low incidence of complication.It is superior to traditional surgical treatment and is worthy of clinical promotion and application.In addition，in internal hemorrhoid sclerotherapy，needle extension length of 9 mm is more valuable in improving the symptoms of prolapse of internal hemorrhoids than needle extension length of 4 mm.

Key words: Third-degree internal hemorrhoids, Endoscope, Sclerotherapy, Needle extension length