Application of polidocanol foam injection sclerotherapy in patients with antithrombotic therapy combined with mixed hemorrhoid bleeding: A single-center experience and literature review

Objective To explore the single-center clinical experience of polydocanol foam in the antithrombotic treatment of mixed hemorrhoid patients with bleeding and review the related literature. Methods From March 2018 to May 2023, we retrospectively analyzed the clinical data of 7 patients who were admitted to the General Surgery Department of Yangpu Hospital affiliated to Tongji University. Patients with antithrombotic therapy combined with mixed hemorrhoid bleeding who failed to receive conservative treatment need to be treated with polydocanol foam injection sclerotherapy. We summarized the single-center clinical application experience of polydocanol foam injection sclerotherapy in the treatment of patients receiving antithrombotic therapy combined with mixed hemorrhoid bleeding. Through a literature search, the related literature results concerning the application of polydocanol foam sclerotherapy in the antithrombotic treatment of patients with mixed hemorrhoid bleeding were reviewed. Results Seven patients were successfully treated with polydocanol foam sclerotherapy, and the bleeding stopped. The operation time ranged from 10–30 minutes, and no serious complications occurred. At the 4-week postoperative follow-up evaluation, none of the patients had bleeding again, and hemoglobin significantly increased (Hb: 106.0 ± 17.4 g/L vs Hb: 70.9 ± 19.7 g/L). Four weeks after surgery, the overall clinical efficacy rate reached 100%, with a satisfaction rate of 100%. Through a literature review, three studies were ultimately included for analysis. Conclusion Polydocanol foam injection sclerotherapy is a safe and effective method for patients receiving antithrombotic therapy combined with mixed hemorrhoid bleeding. However, larger multicenter prospective studies are needed before this is the preferred treatment for such patients.