Multiple versus single rubber band ligation for internal hemorrhoids: A review of 450 consecutive cases

In the last 10 years we have treated 450 consecutive patients symptomatically affected by 1st- or 2nd-degree hemorrhoids with rubber band ligation. The patients were divided into 2 groups: group A, 216 patients treated from 1983 to 1989, and group B, 234 patients treated from 1990 to 1993. In group A multiple ligations (2 or 3) were made in a single session. In the group B one ligation at a time was performed. In group A satisfactory results were obtained in 78% of the cases, whereas in group B the results were good in 91% of patients (p < 0.01). Complications also decreased: bleeding decreased from 25 to 5% and pain from 22 to 9% (p < 0.01). Sepsis was present in 30% of the group-A cases, but was never seen in group B. In conclusion rubber band ligation offers better results if it is made with one ligation at a time, repeating the operation every 4 weeks. © 1997 S. Karger AG, Basel.