ENDOSCOPIC HEMORRHOIDAL LIGATION - PRELIMINARY CLINICAL-EXPERIENCE

Background: Endoscopic hemorrhoidal ligation may provide an alternativ e to surgical treatment of internal hemorrhoids.This study assessed th e safety and efficacy of endoscopic elastic band ligation for bleeding internal hemorrhoids. Methods: Endoscopic hemorrhoid ligation was per formed in 20 adult patients who had chronic rectal bleeding attributed to internal hemorrhoids. Elastic band ligation was accomplished using a ligating device attached to the end of a video endoscope. Repeat en doscopy was done 3 weeks after the initial procedure. Results: Seventy band ligations were performed during 23 separate sessions. Post-thera py endoscopy showed reduction of hemorrhoidal size by at least one gra de in 19 of 20 patients (95%). Bleeding resolved in 19 of 20 patients (95%) in 5.4 months (mean) of follow-up; 18 of 20 (90%) required only one banding session. No major complications (perforation, secondary bl eeding, deep ulceration) occurred in this small group. Conclusions: Pr eliminary data indicates that endoscopic hemorrhoidal ligation is a sa fe and effective technique for treating internal hemorrhoids. It holds promise as an important technique for successfully treating and possi bly eradicating symptomatic internal hemorrhoids.