EP609 - Comparison of rubber band ligation versus haemorrhoidal artery ligation for second-degree and third-degree haemorrhoids: A systematic review and meta-analysis.

Monday, May 12, 2025

8:10 AM – 8:15 AM PT

Location: Monitor 2, Sails Pavilion, Upper Level

ePoster Presenter(s)

AM

Ali Mohamedahmed, MBBS, MSc, MRCS, MD

Speciality Registrar
University Hospitals of Derby and Burton NHS Trust
Leicester, England, United Kingdom

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

SA

Sabry Abounozha, MBBS, MRCS

Registrar
Sunderland Royal Hospital
Sunderland, England, United Kingdom

Disclosure information not submitted.
TS

Tamer Saafan, MBBS, MRCS

Registrar
Cumberland Infirmary Hospital
Carlisle, England, United Kingdom

Disclosure information not submitted.
RI

Rashid Ibrahim, MBBS, MRCS

Registrar
Salford Royal Foundation Trust
Manchester, England, United Kingdom

Disclosure information not submitted.
NH

Najam Husain, MBBS,FCPS,FEBS Coloproct,FRCS,FACS

Consultant of colorectal surgery
University Hospitals of Derby and Burton NHS Trust
Burton on Trent, England, United Kingdom

Disclosure information not submitted.

Senior Author(s)

PT

Pradeep Thomas, MBBS, FRCS

Consultant of colorectal surgery
University Hospitals of Derby and Burton NHS Trust
Burton on Trent, England, United Kingdom

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Ali Mohamedahmed, MBBS, MSc, MRCS, MD: This individual has no financial relationships with ineligible companies.

Pradeep Thomas, MBBS, FRCS: This individual has no financial relationships with ineligible companies.

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Purpose/Background: With an estimated incidence of 4%, haemorrhoidal disease is a common problem worldwide, and second-degree and third-degree are considered the most common types. This systematic review investigates the outcomes of rubber band ligation (RBL) versus haemorrhoidal artery ligation (HAL) for second-degree and third-degree haemorrhoids.

Methods/Interventions: This systematic review was designed, performed, and reported as per the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines. Literature databases, including PubMed, Cochrane, Science Direct and Google Scholar, were searched for studies comparing rubber band ligation versus haemorrhoidal artery ligation for second-degree and third-degree haemorrhoids. The primary outcome was the recurrence of haemorrhoids, while post-operative bleeding, postoperative pain, surgical site infection and success rate were the secondary outcomes. The meta-analysis was performed using RevMan version 5.4.

Results/Outcomes: The literature search and inclusion criteria identified five studies (n = 953) comparing HAL (n = 548) versus RBL (n = 405). The recurrence rate was higher in the RBL group (28.4%) compared to the HAL group (19.3%) [odd ratio (OR) 0.56, P= 0.001] (Figure 1). The two groups showed comparable results regarding postoperative pain (OR 1.12, P= 0.79), postoperative bleeding (OR 1.77, P= 0.22), and surgical site infection (Risk difference 0.00, P= 0.67). Moreover, the short-term success rate was 85.6% in HAL compared to 86.3% in RBL (P= 0.81).

Conclusion/Discussion: Rubber band ligation and haemorrhoidal artery ligation showed comparable short-term outcomes regarding symptoms treatment, post-operative bleeding and pain. However, HAL was superior in terms of recurrence rate.