Zu N, Jing X, Zhou XY, Ma BB, Wang SJ, Qi XS, Liu LB. Endoscopic rubber band ligation, injection sclerotherapy, and sclerobanding for the treatment of internal hemorrhoids. World J Gastroenterol 2026; 32(5): 116007 [DOI: 10.3748/wjg.v32.i5.116007]
Corresponding Author of This Article
Li-Bin Liu, PhD, Doctor, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong Province, China. liulibin@qdu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Feb 7, 2026 (publication date) through Jan 28, 2026
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Gastroenterology
ISSN
1007-9327
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Zu N, Jing X, Zhou XY, Ma BB, Wang SJ, Qi XS, Liu LB. Endoscopic rubber band ligation, injection sclerotherapy, and sclerobanding for the treatment of internal hemorrhoids. World J Gastroenterol 2026; 32(5): 116007 [DOI: 10.3748/wjg.v32.i5.116007]
World J Gastroenterol. Feb 7, 2026; 32(5): 116007 Published online Feb 7, 2026. doi: 10.3748/wjg.v32.i5.116007
Endoscopic rubber band ligation, injection sclerotherapy, and sclerobanding for the treatment of internal hemorrhoids
Na Zu, Xue Jing, Xin-Yu Zhou, Bei-Bei Ma, Shi-Jin Wang, Xing-Si Qi, Li-Bin Liu
Na Zu, Xin-Yu Zhou, Qingdao University Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
Xue Jing, Bei-Bei Ma, Shi-Jin Wang, Xing-Si Qi, Li-Bin Liu, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
Co-first authors: Na Zu and Xue Jing.
Co-corresponding authors: Xing-Si Qi and Li-Bin Liu.
Author contributions: Zu N and Jing X designed and conducted the study and wrote the manuscript; Ma BB, Wang SJ, and Qi XS provided clinical advice and participated in the data acquisition; Zhou XY contributed to the data analysis; Liu LB and Qi XS supervised the study and made critical revisions related to important intellectual content of the manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Qingdao University (No. QYFY WZLL 30480).
Informed consent statement: Informed verbal consent was obtained from all patients during the postoperative follow-up through phone calls. Clinical data were obtained anonymously following the acquisition of written informed consent from each patient for treatment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the first author at 19105496203@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Bin Liu, PhD, Doctor, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No. 59 Haier Road, Qingdao 266000, Shandong Province, China. liulibin@qdu.edu.cn
Received: October 31, 2025 Revised: December 1, 2025 Accepted: December 18, 2025 Published online: February 7, 2026 Processing time: 89 Days and 18.3 Hours
Abstract
BACKGROUND
The clinical outcomes of endoscopic rubber band ligation (ERBL), injection sclerotherapy (IS), and endoscopic polidocanol sclerobanding (ESB) have not yet been well studied.
AIM
To evaluate the efficacy and safety of ERBL, IS, and ESB for treating grade I-III internal hemorrhoids.
METHODS
This retrospective cohort study was performed on 201 patients, who were grouped according to their endoscopic treatment (ERBL, IS, and ESB groups). Postoperative follow-ups were initially carried out at 1, 3, and 6 months, and then every 6 months, with the longest follow-up extending to 24 months. The study analyzed clinical efficacy, short-term and overall recurrence rates, and postoperative adverse events. Additionally, subgroup analysis was conducted based on the internal hemorrhoid grade (I or II-III).
RESULTS
The patient distribution across the ERBL, IS, and ESB groups was 70, 66, and 65, respectively. Both the ERBL and ESB groups demonstrated lower overall recurrence rates compared with the IS group (post-hoc analysis, P’ = 0.024 and P’ = 0.015, respectively). Subgroup analysis revealed that sclerotherapy resulted in a higher total recurrence rate than that achieved by sclerobanding (45.95% vs 19.57%, P’ = 0.03), specifically for grade II-III internal hemorrhoids. No significant difference was found in grade I hemorrhoids. The ERBL group exhibited a higher incidence of postoperative pain, a worse median visual analog scale score, and a longer median duration of pain compared with those reported by the other groups (P < 0.001). This trend was consistent for grade II-III hemorrhoids. No significant differences were found among the three groups regarding clinical efficacy or recurrence rates within 6 months post-surgery, even when examined by subgroup.
CONCLUSION
The three treatments evaluated (ERBL, IS, and ESB) provide durable clinical outcomes for grade I hemorrhoids, with no significant differences in postoperative adverse events. For grade II-III hemorrhoids, ESB possesses the dual advantages of lower recurrence rates and reduced postoperative pain compared with IS and ERBL.
Core Tip: The clinical outcomes of endoscopic rubber band ligation (ERBL), injection sclerotherapy (IS), and endoscopic polidocanol sclerobanding (ESB) for treating grade I-III internal hemorrhoids have been limited in previous research. This study evaluated the efficacy and safety of these three methods, revealing that all provided long-term clinical benefits for grade I hemorrhoids. For grade II-III hemorrhoids, ESB demonstrated superior outcomes, including lower recurrence rates and minimal postoperative pain compared with IS and ERBL.
