Retroflexed endoscopic band ligation of bleeding internal hemorrhoids

Gastrointestinal Endoscopy
Charles Berkelhammer, Syed Bhatool Moosvi

Abstract

Elastic band ligation is a well-established nonoperative method for treatment of bleeding internal hemorrhoids, stages II-III. Usually, one or two bands are placed at a single session by using rigid instruments. The aim of this study was to assess the feasibility, tolerability, safety, and efficacy of multiple band ligation of internal hemorrhoids performed in one session by using a flexible endoscope with an attached band ligation device in the retroflexed position. Eighty-three patients with chronically bleeding and/or prolapsing internal hemorrhoids were treated by retroflexed endoscopic band ligation. From 1 to 6 bands were placed in a single session. Bands were targeted at the apex and proximal body of the internal hemorrhoid so that final band placement was entirely proximal to the dentate line. Malpositioned bands were removed by using a novel method. Patients were followed prospectively to assess tolerance, complications, and efficacy. Retreatment was offered if the desired result was not achieved. A mean of 3.0 (SD 1.2) bands (range 1-6) were placed in a single session. Five percent of bands were malpositioned and removed. Patients were followed for 26 (17) months (range 1-52 months). An excellent result was achieved i...Continue Reading

Citations

Aug 2, 2007·Journal of Pediatric Gastroenterology and Nutrition·Marsha H Kay, Robert Wyllie
Nov 26, 2008·World Journal of Gastroenterology : WJG·Abdo Saad, Douglas-Kevin Rex
Apr 1, 2011·Clinical Journal of Gastroenterology·Takahiro SatoJouji Toyota
Sep 10, 2003·Current Gastroenterology Reports·Swarna Balasubramaniam, Andreas M Kaiser
Oct 11, 2016·World Journal of Gastrointestinal Surgery·Andreia Albuquerque
Jun 26, 2012·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Takahiro SatoJun Akaike
Dec 22, 2004·Journal of Gastroenterology and Hepatology·Akihisa FukudaTsutomu Chiba
Jan 30, 2021·Journal of Translational Internal Medicine·Wenzhuang MaSiyu Sun
Feb 24, 2004·Gastroenterology·Yolanda Scarlett

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