The short-term clinical outcomes of endoscopic rubber band ligation for grade I~III internal hemorrhoids

Abstract

Background To investigate the short-term safety and efficacy of endoscopic rubber band ligation (ERBL) for grade I~III internal hemorrhoids, and to analyze the related factors of adverse events after ERBL. Methods The clinical data of 266 patients with grade I~III internal hemorrhoids treated by ERBL in Henan Provincial People's Hospital from January 2021 to June 2023 were retrospectively analyzed. According to the Goligher’s grading of internal hemorrhoids, the patients were divided into three groups: grade I (98 patients), grade II (56 patients) and grade III internal hemorrhoids (112 patients). The clinical efficacy and adverse events (AEs) 24h after ERBL of the three groups were compared and analyzed. Results The effectiveness rate of grade I, II and III internal hemorrhoids were 88.8%, 87.5% and 86.6%, respectively, with no statistical difference (p>0.05). A total of 107 (40.2%) patients had AEs 24h after ERBL, of which 11 (4.1%) had postoperative bleeding, 48 (18.0%) had anal pain, 80 (30.1%) had sense of anal sagging, and 15 (5.6%) had urinary retention. The postoperative adverse events of grade I, II and III internal hemorrhoids were 42.9% (42/98), 51.8% (29/ 56) and 32.1% (36/112), respectively, and the difference was statistically significant (p<0.05). Univariate and multivariate analysis showed that the suspension ligation was the protective factor for postoperative AEs [OR (95%CI): 9.64 (2.124,43.79), p=0.04]. Conclusions ERBL is effective for grade I~III internal hemorrhoids, but it is safer for grade III internal hemorrhoids. Suspension ligation can reduce postoperative adverse reactions. Multicenter, prospective studies are needed to verify our conclusion.