Hemorrhoidal elastic band ligation during routine colonoscopy: A comparative study between flexible video endoscopy and rigid proctoscopy

Table 1 Classification of internal hemorrhoids according to Dennison

Classification
Grade I	Bleeding during evacuation, without prolapse
Grade II	Prolapse during evacuation with spontaneous return, with or without bleeding
Grade III	Spontaneous prolapse or during evacuation, with manual reduction, with or without bleeding
Grade IV	Externalized and irreducible, and ischemia, thrombosis or gangrene may occur, with or without bleeding

Table 2 Classification of internal hemorrhoid by flexible endoscopy according to the occupation of the anal circumference

Classification
Grade I	Occupies a quarter of the anal circumference
Grade II	Occupies half of the anal circumference
Grade III	Occupies three quarters of the anal circumference
Grade IV	Occupies the entire circumference of the anal circumference

Table 3 Characteristics of patients before band ligation, mean ± SD/median (minimum-maximum)/n (%)

Variable	EBL (n = 75)	RPBL (n = 96)	P value1
Age	53.56 ± 13.1	50.71 ± 13.07	0.19
	56 (27-83)	51 (23-84)
Sex			< 0.01
Female	7 (9.33)	31 (32.29)
Male	68 (90.67)	65 (67.71)
Previous prolapse			0.02
No	0 (0)	7 (7.29)
Yes	75 (100)	89 (92.71)
Previous bleeding			0.50
No	0 (0)	2 (2.08)
Yes	75 (100)	94 (97.92)
Bleeding classification			0.17
B0	3 (4)	2 (2.08)
B1	20 (26.67)	28 (29.17)
B2	22 (29.33)	35 (36.46)
B3	26 (34.67)	31 (32.29)
B4	4 (5.33)	0 (0)
Dennison hemorrhoid grade			0.33
I	1 (1.33)	6 (6.25)
II	52 (69.33)	63 (65.63)
III	22 (29.33)	27 (28.13)
Endoscopic classification of hemorrhoids			0.02
II	13 (17.33)	33 (34.38)
III	62 (82.67)	62 (64.58)
IV	0 (0)	1 (1.04)
Number of bands per session	6.2 ± 0.96	3.21 ± 0.48	< 0.01
	6 (3-7)	3 (2-5)
Number of sessions	1.09 ± 0.29	1.76 ± 0.72	< 0.01
	1 (1-2)	2 (1-4)
Total bands	6.79 ± 2.13	5.58 ± 2.25	< 0.01
	6 (3-14)	6 (2-12)
Follow-up time (months)	41.27 ± 30.02	59.15 ± 62.29	0.64
	39.14 (0.1-138.52)	38.08 (1.18-225.23)

¹Fisher’s exact test was used for qualitative variables and the Mann-Whitney U test for quantitative variables.

Bleeding intensity before band ligation, B0 - without bleeding; B1 - light, sporadic bleeding, only when cleaning; B2 - moderate bleeding, mixed with feces; B3 - intense bleeding, drip in the toilet; B4 - anemia. EBL: Endoscopic band ligation; RPBL: Rigid proctoscope band ligation.

Table 4 Results after band ligation, mean ± SD/median (minimum-maximum)/n (%)

Variable	EBL (n = 75)	RPBL (n = 96)	P value1
Age	53.56 ± 13.1	50.71 ± 13.07	0.19
	56 (27-83)	51 (23-84)
Sex			< 0.01
Female	7 (9.33)	31 (32.29)
Male	68 (90.67)	65 (67.71)
Previous prolapse			0.02
No	0 (0)	7 (7.29)
Yes	75 (100)	89 (92.71)
Previous bleeding			0.50
No	0 (0)	2 (2.08)
Yes	75 (100)	94 (97.92)
Bleeding classification			0.17
B0	3 (4)	2 (2.08)
B1	20 (26.67)	28 (29.17)
B2	22 (29.33)	35 (36.46)
B3	26 (34.67)	31 (32.29)
B4	4 (5.33)	0 (0)
Dennison hemorrhoid grade			0.33
I	1 (1.33)	6 (6.25)
II	52 (69.33)	63 (65.63)
III	22 (29.33)	27 (28.13)
Endoscopic classification of hemorrhoids			0.02
II	13 (17.33)	33 (34.38)
III	62 (82.67)	62 (64.58)
IV	0 (0)	1 (1.04)
Number of bands per session	6.2 ± 0.96	3.21 ± 0.48	< 0.01
	6 (3-7)	3 (2-5)
Number of sessions	1.09 ± 0.29	1.76 ± 0.72	< 0.01
	1 (1-2)	2 (1-4)
Total bands	6.79 ± 2.13	5.58 ± 2.25	< 0.01
	6 (3-14)	6 (2-12)
Follow-up time (months)	41.27 ± 30.02	59.15 ± 62.29	0.64
	39.14 (0.1-138.52)	38.08 (1.18-225.23)

¹Fisher’s exact test was used for qualitative variables and the Mann-Whitney U test for quantitative variables.

Bleeding intensity before band ligation, B0 - without bleeding; B1 - light, sporadic bleeding, only when cleaning; B2 - moderate bleeding, mixed with feces; B3 - intense bleeding, drip in the toilet; B4 - anemia. EBL: Endoscopic band ligation; RPBL: Rigid proctoscope band ligation.