Foam sclerotherapy with Fibrovein (STD) for the treatment of hemorrhoids, using a flexible endoscope

AIM: This case study was designed to evaluate foam sclerotherapy of hemorrhoidal disease using a flexible endoscope. METHODS: We treated 250 patients of grade II-IV hemorrhoids with Sotradecol foam. To obtain sclerosing foam, we used a special foam kit, which produced a stable and standardized sclerosing foam. The quantity of foam injected into the hemorrhoids was 1 to 2 cc with a total of 6 cc for each session. Variables to assess efficacy of treatment were: pain, bleeding and prolapse. RESULTS: Generally, bleeding and hemorrhoidal prolapse were resolved with at most two sclerotherapy sessions. However, pain usually had disappeared after the first session. No complications such as mucosal erosions at the foam injection site, formation of abscesses, bacteraemia, or fistulas occurred. CONCLUSION: The advantages of sclerosing foam are its adhesiveness and compactness, its greater volume, its increased spasm generation, and the greater sclerosing power. Sclero-therapy with foam makes it possible to reach optimal results with small amounts of sclerosing agent and fewer risks of complications.