Rubber Band Ligation of Hemorrhoids: A Single-Center Study of Efficacy and Predictors of Recurrence

Aims Rubber band ligation (RBL) is a common therapeutic alternative in the management of hemorrhoidal disease because of its safety, availability and effectiveness. Our study aimed at evaluating the results of RBL of hemorrhoids, and investigating the predictors of disease recurrence after the procedure.

Methods A retrospective study was conducted, including patients with symptomatic internal hemorrhoids treated with RBL on an outpatient basis by the same operator (January 2013- January 2020). Data about patient’s characteristics, ligation procedure and results were collected.

Results A total of 43 patients (median age: 42 y. (20-88y.); 34 males) were included. RBL was performed because of failure of medical treatment in 30 patients (70 %). Seventeen (40 %) and 26 (60 %) patients presented with prolapse and rectal bleeding, respectively. The mean follow-up period was 24 mo. (3-48mo.). RBL effectiveness at 6 months, 1 year, and 2 years were 92 %, 87 % and 76 %, respectively. Recurrence was observed in 29 % of cases within an average of 6 mo. (1-12mo.). In terms of complications, three cases of external hemorrhoidal thrombosis, one case of anal abscess and two cases of pressure ulcer fall were noted. Four patients had surgery after failure of instrumental treatment or its contraindication. The predictive factors of recurrence of hemorrhoidal disease were: age> 50 years (p = 0.04) and absence of improvement in constipation under well-managed symptomatic treatment (p = 0.02). No significant association was revealed with gender (p = 0.3), grade of internal hemorrhoids (p = 0.2), number of hemorrhoidal bundles (p = 0.3), antiaggregant or anticoagulant treatment (p = 0.3) and hypertonia of anal sphincter on rectal examination (p = 0.08).

Conclusions RBL of hemorrhoids was associated with an efficiency rate of 87 % at 1 year with a low complication rate. The main predictor of recurrence was the lack of improvement in constipation

Citation: Laabidi S, Bouchabou B, Ghribi M etal. eP276 RUBBER BAND LIGATION OF HEMORRHOIDS: A SINGLE-CENTER STUDY OF EFFICACY AND PREDICTORS OF RECURRENCE. Endoscopy 2021; 53: S188.

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Artikel online veröffentlicht:
19. März 2021