Clinical Efficacy Analysis of Different Numbers of Endoscopic Multi-Band Ligation in the Treatment of Grade Ⅱ-Ⅲ Internal Hemorrhoids

Corresponding author: chen yi jin, 879561010@qq.com

DOI: 10.12201/bmr.202603.00059

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  Abstract: Abstract Objective To investigate the impact of different numbers of ligation bands on the efficacy and adverse reaction profiles of endoscopic multi-band ligation for grade II-III internal hemorrhoids, and to guide the individualized treatment of this condition.Methods A retrospective analysis was conducted on the clinical data of 554 consecutive patients with grade Ⅱ-Ⅲ internal hemorrhoids admitted between June 2020 and December 2024. Patients were divided into two groups based on the number of ligation bands: Group A (4-5 bands), and Group B (6-7 bands). Due to significant differences in the distribution of hemorrhoid grades between groups (P<0.01), stratified analysis was performed to control for confounding. Efficacy and postoperative adverse reactions were compared within the grade Ⅱ and grade Ⅲ subgroups. Multivariate logistic regression analysis was performed to determine the independent risk factors affecting treatment efficacy and the incidence of postoperative adverse reactions. Results Both overall and stratified analyses showed no statistically significant difference in total efficacy rates or incidence of postoperative bleeding between group A and group B (P>0.05). Visual analogue scale (VAS) scores for anal pain at 1 h, 24 h, and 48 h in Group B were significantly higher than those in Group A (P<0.05). The incidences of anal distention,difficult defecation, and urinary retention were also significantly higher in Group B (P<0.05). Multivariate logistic regression indicated that the number of ligation bands was an independent risk factor for postoperative pain, anal distention, and urinary retention in both grade Ⅱ and grade Ⅲ hemorrhoid patients (P<0.05). Gender, age, and disease duration showed no significant independent influence on treatment efficacy or the aforementioned adverse reactions (P>0.05). Conclusion Endoscopic multi-band ligation is safe and effective for grade Ⅱ-Ⅲ internal hemorrhoids. Increasing the number of ligation bands within the same hemorrhoid grade does not improve therapeutic efficacy, but raises the risk of postoperative adverse reactions, including pain, anal distention, and urinary retention. The number of ligation bands is identified as an independent risk factor for these postoperative adverse events.

  Key words: Internal Hemorrhoids; Endoscopic Multi-band Ligation; Number of Ligation Bands; Efficacy; Adverse Reactions

  Submit time: 17 March 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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