International Journal of Colorectal Disease

, Volume 24, Issue 9, pp 1007–1010 | Cite as

Long-term result after rubber band ligation for haemorrhoids

  • Antonio Forlini
  • Antonio Manzelli
  • Silvia Quaresima
  • Massimo Forlini
Original Article



Rubber band ligation (RBL) is a well-known and recognised outpatient procedure utilised for the treatment of symptomatic internal haemorrhoids. This paper describes a retrospective study which analyses the short- and long-term results of a personal series of patients.

Materials and methods

A consecutive group of 206 patients with symptomatic internal second- and third-degree haemorrhoids were treated with RBL as outpatients from 1982 to 1989. Two or three piles were legated in a single session. All patients were systematically visited after 1 month and 1 year. Respectively after 10 and 17 years, all the patients were contacted to obtain a telephone follow-up.


The short-term follow-up at 1 month and at 1 year showed that 46% of the patients experienced moderate anal pain for 24 h post procedure. Two patients had severe pain (1%) and were admitted in the hospital to be submitted to an operative haemorrhoidectomy within a few days. Only 2.4% of the patients experienced rectal bleeding after a week, and 20% had a second session of RBL after 1 month. At 1 year follow-up, 90% of the patients with second-degree piles and 75% of patients with third-degree piles reported no residual symptoms. The long-term telephone follow-up at 10 and 17 years collected the history of 138 patients (67%). A group of 69% was asymptomatic, 28% had residual symptoms, and 3% needed further surgery.


RBL is a safe and effective treatment for symptomatic internal haemorrhoids. Our long-term follow-up demonstrated good long-term results for internal second- and third-degree haemorrhoids.


Rubber band ligation Haemorrhoids Anorectal disease Piles 


  1. 1.
    Goligher JC (1980) Surgery of the anus, rectum and colon, 4th edn. Bailliere Tindall, LondonGoogle Scholar
  2. 2.
    Alexander-Williams J (1982) The management of piles. Br Med J (Clin Res Ed) 285(6349):1137–1139CrossRefGoogle Scholar
  3. 3.
    Leff E (1987) Hemorrhoids. Postgrad Med 82(7):95–101PubMedGoogle Scholar
  4. 4.
    MacRae HM, McLeod RS (1995) Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 38(7):687–694PubMedCrossRefGoogle Scholar
  5. 5.
    Keighley MRB, Williams NS (1999) Surgery of the anus, rectum and colon, 2nd edn. Saunders WB, LondonGoogle Scholar
  6. 6.
    Law WL, Chu KW (1999) Triple rubber band ligation for hemorrhoids: prospective, randomized trial of use of local anesthetic injection. Dis Colon Rectum 42(3):363–366PubMedCrossRefGoogle Scholar
  7. 7.
    Khubchandani IT (1983) A randomized comparison of single and multiple rubber band ligations. Dis Colon Rectum 26(11):705–708PubMedCrossRefGoogle Scholar
  8. 8.
    Poon GP, Chu KW, Lau WY, Lee JM, Yeung C, Fan ST, Yiu TF, Wong SH, Wong KK (1986) Conventional vs. triple rubber band ligation for hemorrhoids. A prospective, randomized trial. Dis Colon Rectum 29(12):836–838PubMedCrossRefGoogle Scholar
  9. 9.
    Hooker GD, Plewes EA, Rajgopal C, Taylor BM (1999) Local injection of bupivacaine after rubber band ligation of hemorrhoids: prospective, randomized study. Dis Colon Rectum 42(2):174–179PubMedCrossRefGoogle Scholar
  10. 10.
    O’Hara VS (1980) Fatal clostridial infection following hemorrhoidal banding. Dis Colon Rectum 23(8):570–571PubMedCrossRefGoogle Scholar
  11. 11.
    Russell TR, Donohue JH (1985) Hemorrhoidal banding A warning. Dis Colon Rectum 28(5):291–293PubMedCrossRefGoogle Scholar
  12. 12.
    Pissiotis CA, Komborozos VA, Skrekas GJ (2000) Rubber band ligationof symptomatic internal hemorrhoids: result of 500 cases. Dig Surg 17:71–76PubMedCrossRefGoogle Scholar
  13. 13.
    O’Regan PJ (1999) Disposable device and a minimally invasive technique for rubber band ligation of hemorrhoids. Dis Colon Rectum 42(5):683–685PubMedCrossRefGoogle Scholar
  14. 14.
    Trowers EA, Ganga U, Rizk R, Ojo E, Hodges D (1998) Endoscopic hemorrhoidal ligation: preliminary clinical experience. Gastrointest Endosc 48(1):49–52PubMedCrossRefGoogle Scholar
  15. 15.
    El Nakeeb AM, Fikry AA, Omar WH, Fouda EM, El Metwally TA, Ghazy HE, Badr SA, Abu Elkhar MY, Elawady SM, Abd Elmoniam HH, Khafagy WW, Morshed MM, El Lithy RE, Farid ME (2008) Rubberband ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol 14(42):6525–6530PubMedCrossRefGoogle Scholar
  16. 16.
    Bernal JC, Enguix M, Lopéz Garcia J, Garcia Romero J, Trullenque (2003) Rubber-band ligation for hemorrhoidsin a colorectal unit.A prospective study. Rev Esp Enferm Dig 96:38–45Google Scholar
  17. 17.
    Longman RJ, Thomson WHF (2005) A prospective study of outcome from band ligation of piles. Colorectal diseases 8:145–148CrossRefGoogle Scholar
  18. 18.
    Iyer VS, Shrier I, Gordon PH (2004) Long term outcome of Rubber Band Ligation for symptomatic primary and recurrent internal haemorrhoids. Colon rectum 47:1364–1370Google Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Antonio Forlini
    • 1
  • Antonio Manzelli
    • 1
  • Silvia Quaresima
    • 1
  • Massimo Forlini
    • 1
  1. 1.Department of Surgery, General Surgery DivisionTor Vergata University Hospital, Tor Vergata UniversityRomeItaly

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