Objective To evaluate the methodology, feasibility, safety and efficacy of cap-assisted endoscopic sclerotherapy(CAES)for hemorrhoids. Methods Patients with grade Ⅰ to Ⅲ internal hemorrhoids underwent CAES from September 2014 to May 2016. According to the methodology of CAES, reasons for blooding were identified and polypectomy and excision of anal papilla fibroma was performed. Efficacy,intraoperative and postoperative complications and patient satisfaction were evaluated during and after CAES. The follow-up was more than three months. Results A total of 48 patients with gradeⅠ toⅢinternal hemorrhoids underwent CAES,including 25(52.1%)patients with grade Ⅰ,21(43.8%)patients with grade Ⅱ,and 2(4.2%)grade Ⅲ. During the whole procedure of CAES, colon and terminal ileum examination was performed in 48(100.0%)patients, polypectomy was performed in 14(29.2%)patients, excision of anal papilla fibroma was performed in 1(2.1%)patient, excision of external hemorrhoids was performed in 1(2.1%)patient,biopsy for the polyps on dentate line was performed in 2(4.2%)patients, and sclerotherapy for rectal mucosal prolapse was performed in 2(4.2%)patients. No bleeding was observed during and after CAES. Infection occurred in one(2.1%)patient, who recovered with a one-week anti-infective therapy. One(2.1%)patient claimed mild tenesmus within four days after CAES.No complications were observed within the three-month follow-up. All patients(100.0%)were satisfied with this novel procedure. Conclusion CAES, as a novel endoscopic sclerotherapy, is a safe and effective endoscopic therapy with high patient satisfaction for internal hemorrhoids.

Objective: To evaluate the methodology, safety and clinical applications of colonic transendoscopic enteral tubing (TET) as a new method of fecal microbiota transplantation (FMT) and colonic administration. Methods: This prospective study included patients who underwent colonic TET for FMT and(or) colonic administration in the Second Affiliated Hospital of Nanjing Medical University from October 2014 to December 2018. The TET procedure time, success rate, retention time of TET tube, factors influencing TET tube retention, adverse events and satisfaction degree were evaluated. Results: A total of 257 patients underwent TET, among whom 130 patients (50.6%) for microbiota tronsplantation, 8 patients (3.1%) for colon-drip medication, 118 patients (45.9%) for FMT and colon-drip medication, and 1 patient (0.4%) without treatment after TET. The TET procedure time was 10.0±2.8 min. The number of endoscopic clips used was 3.5±1.0. The success rate of the TET procedure was 100.0% (257/257). The retention time of TET tube for 160 patients maintaining the tube for treatment was 9.3±3.8 days. Multivariate analysis indicated that endoscopic clip type (P=0.001) was an independent influencing factor for the retention time of the tube. A total of 9 patients (3.5%) reported adverse events of mild anus discomfort, 4 patients (1.6%) of mobile inconvenience, 3 (1.2%) of anal pain, 2 (0.8%) of mild abdominal pain, 2 (0.8%) of mild bloating, and 1 (0.4%) of mild anal bleeding. No severe adverse events were observed in this study. The total satisfaction degree on colonic TET was 97.3% (250/257) in all patients. Conclusion The colonic TET, a safe and easy-operating endoscopic interventional technology with a high degree of patients satisfaction, can be used for colonic delivering of FMT and medications for various diseases.