Efficacy and Safety of Endoscopic Super-Hemorrhoidal Banding for Mixed Hemorrhoids with Prolapse

Abstract

Objective Traditional miligan-organ hemorrhoidectomy (MMH) has disadvantages for mixed hemorrhoids with prolapse. Strategies to further improve the therapeutic effect, reduce postoperative anal pain, and decrease the complication rate are urgently required. We investigated the efficacy and safety of endoscopic superhemorrhoidal banding (ESHB) for mixed hemorrhoids with prolapse. Methods The clinical data of 130 consecutive patients with mixed hemorrhoids and prolapse at the People's Hospital of Qiandongnan Miao and Dong Autonomous Prefecture from June 2021 to June 2023 were retrospectively collected and analyzed. Sixty-five patients who underwent MMH and 65 who underwent ESHB were categorized into MMH and ESHB groups, respectively. The outcomes, length of the procedure, hospitalization time, postoperative pain (evaluated using the visual analog scale [VAS]), and incidence of urinary retention were compared. Results The efficacy was 100% in both groups, with no statistically significant difference (P > 0.05). Operation length and hospitalization time were significantly shorter in the ESHB group than in the MMH group (P < 0.01). The VAS scores for postoperative pain and incidence of urinary pain were significantly lower in the ESHB group than in the MMH group (P < 0.01). Conclusions ESHB can effectively restore the weakened anal cushion and protect its structural and functional integrity, improve symptoms related to mixed hemorrhoids with prolapse, shorten operative time and hospital stay, and reduce the incidence of postoperative complications. It is a safe and simple minimally invasive endoscopic treatment with an efficacy similar to that of MMH. Trial registration : The clinical trial registration was completed (registration no.: NCT06250140; registration date: January 31, 2024).