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Abstract
Background Symptomatic haemorrhoid disease is one of the most prevalent diseases. Rubber band ligation is the most performed procedure for them. It can be performed either proctoscopy or Endoscopic Guided. However, there is no data comparing the two modalities.
To compare the safety and efficacy of these two modalities of Rubber Band ligation for the treatment of symptomatic Internal Haemorrhoids.
Methods 300 patients who presented to our hospital with rectal bleeding were randomized equally to each group (IDDF2024-ABS-0090 Table 1). One experienced gastroenterologist and a surgeon performed all the procedures. Proctoscopy and Sigmoidoscopy were used for the diagnosis of the haemorrhoids and were classified as per Goligher’s grading. Only Goligher’s grade I to III were enrolled for the study. Endoscopic Band ligation (EBL) was performed in an endoscopy suite in the left lateral position without any sedation as in outpatient cases. The banding was done in a retroflexed position. Proctoscopy-guided Band ligation (PBL) was performed in the outpatient clinic of the surgeon using a gun. The mean follow-up period was 25 months (IQR 21-32 months).
Results 356 sessions of band ligations were performed.7.33% required more than one session in the EBL group compared to 15.33% in the PBL group (p=0.03). The average time of each procedure was about 11± 30 minutes and 8± 20 minutes, respectively (P=0.60). The bands had to be removed within 24 hours in 2.66%of the EBL cases and 7.33%of PBL cases (P=0.04). Mean hospital stay was 2.5 hours (IQR 1 to 4 hours) and 2 hours (IQR 1to3) respectively (p=0.10). Mild to moderate pain and bleeding per rectum were seen in 4.66% and 10.66%of the cases, respectively (p=0.04). All were managed conservatively in both groups. Bleeding was controlled in 95.33% (143/150) and 87.33% (131/150) of the cases (p=0.03). Patient satisfaction was seen in 93.33% and 90.66%of cases, respectively (p=0.2). The recurrence rates of symptomatic Internal Haemorrhoids were 4.66% and 11.33% at 2 years, respectively(p=0.04). (IDDF2024-ABS-0090 Figure 1. Results)
Demographic-table
Results
Conclusions Endoscopic Band ligation (EBL) was safer and more effective modality of treatment than Proctoscopy guided Band ligation (PBL) for Symptomatic Internal Haemorrhoids.