Treatment Outcomes after Endoscopic Band Ligation of Symptomatic Internal Hemorrhoids

Lee, Joon Young; Lim, Sang Ah; Chung, Wonho; Kim, Sung Ho; Koh, Jin Sung; Lim, Eun Hye; Kim, Chang Ha; Joo, Moon Kyung; Lee, Beom Jae; Kim, Ji Hoon; Yeon, Jong Eun; Park, Jong Jae; Kim, Jae Seon; Byun, Kwan Soo; Bak, Young Tae

Abstract

BACKGROUND/AIMS
Elastic band ligation is a well-established method for the treatment of internal hemorrhoids. The aim of this study was to assess the treatment outcomes of flexible endoscopic rubber band ligation of internal hemorrhoids.
METHODS
Using a flexible endoscope, 30 patients with symptomatic internal hemorrhoids were evaluated based on change in clinical symptoms (Goligher grade, bleeding score) and endoscopic classifications (range, size) before and after the procedure.
RESULTS
Goligher grade and bleeding score showed significant improvement after the procedure (Goligher grade from 2.12 to 0.54, p<0.01, and bleeding score from 1.80 to 0.40, p<0.01). Endoscopic classification scores improved significantly after the procedure (range 3.03 to 1.55, p<0.01, and size from 1.80 to 0.85, p<0.01). As a complication, mild pain developed in 19 patients (90.5%) and severe pain in two patients (9.5%). Most (90.5%) were well controlled by conservative management, but one patient was operated on for hemorrhoidal thrombosis and in another patient the ligated rubber band had to be released promptly for pain relief. One patient (3.3%) experienced mild infection, which was relieved by medical treatment. During the 16.7+/-3.2-month period of follow-up, two patients relapsed, one was treated with additional endoscopic band ligation, and one underwent surgery.
CONCLUSIONS
Flexible endoscopic band ligation is an effective and safe method of treatment in patients with symptomatic internal hemorrhoids.