To investigate the long-term efficacy and safety of endoscopic ligation and sclerotherapy for grade Ⅰ-Ⅱ internal hemorrhoids.

Clinical data of patients with grade Ⅰ-Ⅱ internal hemorrhoids admitted to the 960th Hospital of Chinese PLA Joint Logistics Support Force from January 2019 to June 2021 were retrospectively analyzed. They were divided into ligation group (32 cases) and sclerotic group (45 cases) according to different endoscopic treatment methods. The follow-up time was 36-63 months, with a median follow-up time of 47.5 months. The therapeutic effect, recurrence, satisfaction and complications of the two groups were compared.

The cure rate, effective rate and total effective rate of the two groups were compared, which were 84.4%, 12.5% and 96.9% in the ligation group and 77.8%, 20.0% and 97.8% in the sclerotic group, respectively. There was no statistically significant difference between the two groups (P>0.05). Among the patients with effective treatment, the recurrence rate in the ligation group was higher than that in the sclerotic group (22.6% vs. 13.6%), but there was no statistically significant difference (P>0.05). The median recurrence time was 13.5 months in the ligation group and 12.0 months in the sclerotic group. Satisfaction was 93.8% in the ligation group and 95.6% in the sclerotic group, and there was no statistically significant difference between the two groups (P>0.05). Postoperative anal pain and anal distension in the ligation group were significantly more severe than those in the sclerotic group (41.6% vs. 2.2%, 56.2% vs. 6.7%), with a statistically significant difference (P<0.05). The incidence of postoperative hemorrhage and fever was lower between the two groups, but there was no statistical difference (P>0.05). During the follow-up period, there were 3 cases of anal fistula and perianal abscess in the ligation group, which occurred 1 month, 6 months, and 12 months after surgery, respectively, and were cured after additional surgery, while no such cases occurred in the sclerotic group.

Both ligation and sclerotherapy have excellent curative effect in the treatment of grade Ⅰ-Ⅱ internal hemorrhoids, with similar effective rate and recurrence rate, but sclerotherapy has a lower incidence of postoperative complications. For mild internal hemorrhoids such as grade Ⅰ-Ⅱ, sclerotherapy may be more advantageous.