The Safety and Efficacy of Endoscopic Rubber Band Ligation for Hemorrhoids: A Systematic Review and Meta-Analysis

Author:

Xu Anjun1,Yang Yangliang1,Wu Dejun1

Affiliation:

1. Pudong Medical Center

Abstract

Abstract Background There are several methods to treat hemorrhoids; however, the most efficient is rubber band ligation (RBL), and the current combination of RBL with endoscopy is called endoscopic rubber band ligation of hemorrhoids (ERBL). This study aimed to compare the efficacy and safety of ERBL and analyze the satisfaction of patients with hemorrhoids.Methods This study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Two authors (Xu, Yang) independently searched PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, and WanFang in April 2022. All eligible Chinese and English records were included in the analysis. Meta-analysis was performed using Review Manager version 5.3.Results A total of 330 articles were identified. Ultimately, 12 articles were included in the analysis. Compared to the control group, patients who underwent ERBL had significantly improved postoperative pain (visual analog scale score) (mean difference = -1.26, 95% confidence interval [CI] [-1.85, -0.68], P < 0.001). Simultaneously, ERBL reduced the incidence of complications such as postoperative bleeding (odd ratio [OR] = 0.31, 95% CI [0.16, 0.62], P = 0.0008), urinary retention (OR = 0.27, 95% CI [0.09, 0.83], P = 0.02), and anal protrusion (OR = 0.09, 95% CI [0.02, 0.36], P = 0.0008). In the postoperative follow-up, compared with other surgical methods in the control group, ERBL significantly increased the effective rate of surgery (OR = 5.77, 95% CI [2.41, 13.78], P < 0.001), decreased the postoperative recurrence rate (OR = 0.39, 95% CI [0.21, 0.74], P = 0.004), and improved patient satisfaction with surgery (OR = 4.3, 95% CI [2.21, 8.37], P < 0.001).Conclusions ERBL improved postoperative pain, reduced complications, and improved postoperative satisfaction in patients with hemorrhoids. These findings are suitable for further research.

Publisher

Research Square Platform LLC

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