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Rubber band ligation of symptomatic hemorrhoids: an old solution to an everyday problem

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of this prospective study is to present the results of rubber band ligation (RBL) in 2635 consecutive patients with 2nd, 3rd, and 4th degree symptomatic hemorrhoids, the pain risk factors, and the applicability of the method in patients with liver cirrhosis and portal hypertension.

Methods

A total of 1256 patients with 2nd, 1159 with 3rd, and 220 with 4th degree hemorrhoids were included in the study. Fifty-seven patients with hemorrhoids had liver cirrhosis and portal hypertension. RBL was performed using St Marks’, McGinvey, and suction ligators. Single ligation was done in 178 patients, while 2457 patients had synchronous multiple ligations, in one (272), two (1289), and three (896 patients) sessions.

Results

After the end of treatment, 86.8% of our patients were asymptomatic and 84.5% remained asymptomatic 2 years later. A total of 593 patients had complications. Thirty required hospitalization, while pain was the most frequent complication (16.16 %). Multiple banding, young age, male sex, and external hemorrhoids were pain risk factors. RBL proved to be safe in 57 patients with coagulation disorders due to cirrhosis. Symptomatic recurrence was detected in 327 out of 2110 patients (15.49%), with repeat RBL in 219 cases and surgery in 108 cases.

Conclusion

RBL is a safe, effective method for treating symptomatic 2nd and 3rd degree hemorrhoids. It can also be applied in selected cases of 4th degree hemorrhoids and patients with cirrhosis and portal hypertension.

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Authors and Affiliations

  1. 4th Department of Surgery, “Evangelismos” Hospital, 7 Korai Str., Kifissia, 14561, Athens, Greece

    Vasileios Komporozos, Vasiliki Ziozia, George Stravodimos & Antonia Papazoglou

  2. University of Piraeus, Piraeus, Greece

    Aikaterini Komporozou

  3. 3th Department of Surgery, “Evangelismos” Hospital, Athens, Greece

    Ageliki Kolinioti

Authors
  1. Vasileios Komporozos
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  2. Vasiliki Ziozia
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  3. Aikaterini Komporozou
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  4. George Stravodimos
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  5. Ageliki Kolinioti
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  6. Antonia Papazoglou
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Contributions

Vasilios Komporozos: method application and composing the “Discussion” section

Antonia Papazoglou: coordination, editing, and correspondence

Vasiliki Ziozia: collection of material and results and writing

Aikaterini Komporozou: statistical analysis

George Stravodimos: collection of material and results and writing

Ageliki Kolinioti: collection of material and results and writing

Corresponding author

Correspondence to Antonia Papazoglou.

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Komporozos, V., Ziozia, V., Komporozou, A. et al. Rubber band ligation of symptomatic hemorrhoids: an old solution to an everyday problem. Int J Colorectal Dis 36, 1723–1729 (2021). https://doi.org/10.1007/s00384-021-03900-2

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