title: Cap-assisted endoscopic sclerotherapy for hemorrhoids: Methods, feasibility and efficacy.
abstract: OBJECTIVE
  To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy (CAES) for internal hemorrhoids.
  
  
  METHODS
  A pilot study on CAES for grade I to III internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent.
  
  
  RESULTS
  A total of 30 patients with grade I to III internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One (3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma.
  
  
  CONCLUSIONS
  CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids.
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Xu
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xiang
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: He
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Zhao-Yuan
authors.initials: ZY
authors.lastname: Peng
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Guang-Ming
authors.initials: GM
authors.lastname: Huang
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Guo-Zhong
authors.initials: GZ
authors.lastname: Ji
authors.affiliation: Ting Zhang, Li-Juan Xu, Jie Xiang, Zhi He, Zhao-Yuan Peng, Guang-Ming Huang, Guo-Zhong Ji, Fa-Ming Zhang, Medical Center for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu Province, China.
authors.forename: Fa-Ming
authors.initials: FM
authors.lastname: Zhang
keywords: Cap-assisted endoscopic sclerotherapy; Colon; Colonoscopy; Hemorrhoidal disease; Hemorrhoids; Papilla fibroma; Sclerotherapy