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Nonsurgical treatment of actively bleeding internal hemorrhoids with a novel endoscopic device (with video)

机译：用新型内窥镜设备主动手术治疗内痔出血的非手术治疗（视频）

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Background: Internal hemorrhoids often present with bleeding, prolapse, and other symptoms. Currently used nonsurgical treatment modalities have limited effectiveness and usually require several treatment sessions.Objective: To evaluate effectiveness and safety of a novel endoscopic device for nonsurgical treatment of internal hemorrhoids.Design: Retrospective study.Setting: Single center.Patients: This study involved 23 patients with actively bleeding internal hemorrhoids.Intervention: The HET Bipolar System is a modified anoscope, with a treatment window, light source, and tissue temperature monitor. The device is inserted into the rectum under direct observation. The tissue carrying superior hemorrhoidal branches and the apex of the internal hemorrhoid is positioned inside the treatment window, clamped with incorporated tissue forceps, and treated with bipolar energy to ligate hemorrhoidal feeding vessels.Main Outcome Measurements: Rate of hemorrhoidal bleeding after the treatment.Results: The mean age of the patients was 64.3 ±9.9 years (range 44-79 years). Eleven patients (47.8%) had grade I hemorrhoids and 12 patients (52.2%) had grade II hemorrhoids. In 18 patients (78.3%), treatment with the HET System was performed with the patient under conscious sedation. Five patients (21.7%) were treated without sedation. All patients tolerated treatment without complaints. The average follow-up period was 11.2 ± 4.7 months. No bleeding or prolapse occurred after the procedure in any of the treated patients.Limitations: Retrospective study.Conclusion: The newly developed HET System is easy to use, safe, and highly effective in eliminating bleeding in grade I and II internal hemorrhoids and prolapse in grade II internal hemorrhoids.
机译：背景：内部痔疮常伴有出血，脱垂和其他症状。当前使用的非手术治疗方式效果有限，通常需要进行几次治疗目的：评估新型内窥镜装置用于非手术治疗内痔的有效性和安全性设计：回顾性研究地点：单个中心患者：本研究涉及23内痔出血活跃的患者。干预：HET双极系统是一种改良的肛门镜，具有治疗窗，光源和组织温度监控器。在直接观察下将设备插入直肠。将具有上痔分支和内痔顶点的组织置于治疗窗内，用合并的组织钳夹住，并用双极能量治疗以结扎痔食管。主要观察指标：治疗后痔疮出血率。 ：患者的平均年龄为64.3±9.9岁（范围44-79岁）。 11例（47.8％）患有I级痔疮，12例（52.2％）患有II级痔疮。在18例患者中（78.3％），在有意识的镇静作用下对患者进行了HET系统治疗。五例患者（21.7％）未经镇静治疗。所有患者均耐受治疗而无不适。平均随访时间为11.2±4.7个月。局限性：回顾性研究。结论：新开发的HET系统易于使用，安全且在消除I级和II级内痔出血和脱垂方面非常有效。 II级内部痔疮。

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