{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:13:10Z","timestamp":1774422790496,"version":"3.50.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hemorrhoids is one of the most common anorectal diseases. In recent years, the incidence rate of hemorrhoids has been rising.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the efficacy and safety of combined endoscopic rubber band ligation (ERBL) in the treatment of grade II-III prolapsed internal hemorrhoids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with grade II-III prolapsed internal hemorrhoids treated from January 2019 to June 2023 were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Complete resolution was achieved in 124 cases (91.85%), partial resolution in 7 cases (5.19%), and recurrence in 4 cases (2.96%). 34 (25.19%) cases experienced anal pain after procedure, with a median visual analog scale (VAS) score of 0 (0\u20133). Postoperative bleeding occurred in 18 (13.33%) cases. Anal swelling was observed in 19 (14.07%) cases, and urinary retention occurred in 4 cases (2.96%). The incidence of postoperative pain (30.43% vs. 11.6%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.018) and VAS scores (0 vs. 0,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.003) in the ligate three hemorrhoids group were significantly higher compared to the ligate two hemorrhoids group. There was no significant difference in long-term efficacy between the two groups. Male [odds ratio (OR) 5.654, 95% confidence interval (CI) 1.222\u201326.159;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.027] and postoperative complications (OR 4.914, 95% CI 1.080\u201322.345;\n                      <jats:italic>P<\/jats:italic>\n                      = 0.039) were independent risk factors that were incomplete resolution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Combined ERBL is an efficient and safe method for grade II-III prolapsed internal hemorrhoids. The number of hemorrhoids ligated had no significant effect on the long-term outcome, but the ligation of three hemorrhoids was associated with an increased incidence of postoperative pain. Male and postoperative complications are risk factors for incomplete resolution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1755971","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:44:00Z","timestamp":1774417440000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of combined endoscopic rubber band ligation in the treatment of grade II-III prolapsed hemorrhoids: a retrospective study (with video)"],"prefix":"10.3389","volume":"13","author":[{"given":"Taiyu","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of gynecology and obstetrics, Wanzai County Hospital of Traditional Chinese Medicine","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Foqiang","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jitao","family":"Ao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanqi","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingying","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University","place":["Nanchang, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, The First Affiliated Hospital of Yichun University, People's Hospital of Wanzai County","place":["Wanzai, Jiangxi, China"]},{"name":"Yichun Clinical Medical Research Center for Gastrointestinal Diseases","place":["Wanzai, Jiangxi, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1628","DOI":"10.11847\/zgggws2017-33-11-22","article-title":"Effects of work-related factors on anorectal diseases in adult residents in China","volume":"33","author":"Chen","year":"2017","journal-title":"Chin J Public Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1097\/DCR.0000000000003276","article-title":"Clinical practice guidelines committee of the American society of colon and rectal surgeons. The American society of colon and rectal surgeons clinical practice guidelines for the management of hemorrhoids","volume":"67","author":"Hawkins","year":"2024","journal-title":"Dis Colon Rectum"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1007\/s00464-024-11491-6","article-title":"Rubber band ligation or shaobei injection for the endoscopic treatment of symptomatic hemorrhoids? A retrospective study","volume":"39","author":"Li","year":"2025","journal-title":"Surg Endosc"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2431","DOI":"10.3748\/wjg.v17.i19.2431","article-title":"Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids","volume":"17","author":"Su","year":"2011","journal-title":"World J Gastroenterol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"676","DOI":"10.3760\/cma.j.cn321463-20210526-00340","article-title":"Chinese digestive endoscopic practice guide lines and operation consensus for internal hemorrhoids (2021)","volume":"38","year":"2021","journal-title":"Chin J Dig Endosc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2747","DOI":"10.1007\/s11845-023-03367-w","article-title":"Comparison of the long-term efficacy and safety of multiple endoscopic rubber band ligations in a single session for varying grades of internal hemorrhoids","volume":"192","author":"Xiong","year":"2023","journal-title":"Ir J Med Sci"},{"key":"B7","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1016\/S0016-5107(03)02818-9","article-title":"Retroflexed endoscopic multiple band ligation of symptomatic internal hemorrhoids","volume":"59","author":"Fukuda","year":"2004","journal-title":"Gastrointest Endosc"},{"key":"B8","doi-asserted-by":"publisher","first-page":"6235","DOI":"10.1007\/s00464-023-10108-8","article-title":"Efficacy of two endoscopic rubber band ligation methods for symptomatic hemorrhoids: a randomized controlled trial","volume":"37","author":"Tian","year":"2023","journal-title":"Surg Endosc"},{"key":"B9","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/BF02048023","article-title":"Comparison of hemorrhoidal treatment modalities. A meta-analysis","volume":"38","author":"MacRae","year":"1995","journal-title":"Dis Colon Rectum"},{"key":"B10","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.gie.2023.11.054","article-title":"Top tips for successful endoscopic hemorrhoid banding (with video)","volume":"99","author":"Qureshi","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/DCR.0000000000001234","article-title":"Hemorrhoidal disease symptom score and short health ScaleHD: new tools to evaluate symptoms and health-related quality of life in hemorrhoidal disease","volume":"62","author":"R\u00f8rvik","year":"2019","journal-title":"Dis Colon Rectum"},{"key":"B12","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s10151-021-02430-x","article-title":"Rubber band ligation versus haemorrhoidectomy for the treatment of grade II-III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials","volume":"25","author":"Dekker","year":"2021","journal-title":"Tech Coloproctol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1007\/s00595-013-0564-y","article-title":"Prospective study comparing the new sclerotherapy and hemorrhoidectomy in terms of therapeutic outcomes at 4 years after the treatment","volume":"44","author":"Yano","year":"2014","journal-title":"Surg Today"},{"key":"B14","doi-asserted-by":"publisher","first-page":"356","DOI":"10.1016\/S0140-6736(16)30584-0","article-title":"HubBLe Study team. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial","volume":"388","author":"Brown","year":"2016","journal-title":"Lancet"},{"key":"B15","first-page":"14","article-title":"Comparison of hemorrhoidal treatments: a meta-analysis","volume":"40","author":"MacRae","year":"1997","journal-title":"Can J Surg"},{"key":"B16","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1159\/000522171","article-title":"Office-based procedures in the management of hemorrhoidal disease: rubber band ligation versus sclerotherapy - systematic review and meta-analysis","volume":"29","author":"Salgueiro","year":"2022","journal-title":"GE Port J Gastroenterol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"zrab014","DOI":"10.1093\/bjsopen\/zrab014","article-title":"Improvement in quality of life among Sri Lankan patients with haemorrhoids after invasive treatment: a longitudinal observational study","volume":"5","author":"Keong","year":"2021","journal-title":"BJS Open"},{"key":"B18","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1186\/s12893-022-01688-8","article-title":"Modified rubber band ligation for treatment of grade II\/III hemorrhoids: clinical efficacy and safety evaluation-a retrospective study","volume":"22","author":"Yu","year":"2022","journal-title":"BMC Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1038\/s41395-018-0020-0","article-title":"Office management of hemorrhoids","volume":"113","author":"Qureshi","year":"2018","journal-title":"Am J Gastroenterol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/S0016-5107(04)01551-2","article-title":"Hemorrhoidal elastic band ligation with flexible videoendoscopes: a prospective, randomized comparison with the conventional technique that uses rigid proctoscopes","volume":"60","author":"Wehrmann","year":"2004","journal-title":"Gastrointest Endosc"},{"key":"B21","doi-asserted-by":"publisher","first-page":"614","DOI":"10.4240\/wjgs.v8.i9.614","article-title":"Rubber band ligation of hemorrhoids: a guide for complications","volume":"8","author":"Albuquerque","year":"2016","journal-title":"World J Gastrointest Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"6656","DOI":"10.12998\/wjcc.v10.i19.6656","article-title":"Massive gastrointestinal bleeding after endoscopic rubber band ligation of internal hemorrhoids: a case report","volume":"10","author":"Jiang","year":"2022","journal-title":"World J Clin Cases"},{"key":"B23","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/BF02053512","article-title":"Complications of rubber band ligation of symptomatic internal hemorrhoids","volume":"36","author":"Bat","year":"1993","journal-title":"Dis Colon Rectum"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e184","DOI":"10.1111\/j.1463-1318.2010.02387.x","article-title":"Double jeopardy: pyogenic liver abscess and massive secondary rectal haemorrhage after rubber band ligation of haemorrhoids","volume":"13","author":"Parker","year":"2011","journal-title":"Colorectal Dis"},{"key":"B25","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1007\/BF02554954","article-title":"An unusual complication of rubber band ligation of hemorrhoids","volume":"30","author":"Wechter","year":"1987","journal-title":"Dis Colon Rectum"},{"key":"B26","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/BF02554339","article-title":"Severe complication of rubber band ligation of internal hemorrhoids","volume":"30","author":"Shemesh","year":"1987","journal-title":"Dis Colon Rectum"},{"key":"B27","first-page":"753","article-title":"Multiple pyogenic liver abscesses following hemorrhoid banding","volume":"9","author":"Ergas","year":"2007","journal-title":"Isr Med Assoc J"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2009.10.005","article-title":"Diagnosis and management of symptomatic hemorrhoids","author":"Sneider","year":"2010","journal-title":"Surg Clin North Am"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1007\/s10350-007-0273-y","article-title":"Combined colonoscopy and three-quadrant hemorrhoidal ligation: 500 consecutive cases","volume":"50","author":"Davis","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"B30","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1007\/BF02047212","article-title":"Multiple hemorrhoidal bandings in a single session","volume":"37","author":"Lee","year":"1994","journal-title":"Dis Colon Rectum"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1723","DOI":"10.1007\/s00384-021-03900-2","article-title":"Rubber band ligation of symptomatic hemorrhoids: an old solution to an everyday problem","volume":"36","author":"Komporozos","year":"2021","journal-title":"Int J Colorectal Dis"},{"key":"B32","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1111\/jgh.14857","article-title":"Hemorrhoidal disease and chronic venous insufficiency: Concomitance or coincidence; results of the CHORUS study (Chronic venous and HemORrhoidal diseases evalUation and Scientific research)","volume":"35","author":"Godeberge","year":"2020","journal-title":"J Gastroenterol Hepatol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1186\/s12893-022-01802-w","article-title":"Risk factors of delayed hemorrhage after LigaSure hemorrhoidectomy","volume":"22","author":"Cheng","year":"2022","journal-title":"BMC Surg"},{"key":"B34","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1111\/codi.14852","article-title":"Risk factors associated with unplanned readmission following excisional haemorrhoidectomy","volume":"22","author":"Xia","year":"2020","journal-title":"Colorectal Dis"},{"key":"B35","doi-asserted-by":"publisher","first-page":"542","DOI":"10.1002\/bjs.1800620710","article-title":"The nature of haemorrhoids","volume":"62","author":"Thomson","year":"1975","journal-title":"Br J Surg"},{"key":"B36","doi-asserted-by":"publisher","first-page":"2009","DOI":"10.3748\/wjg.v18.i17.2009","article-title":"Hemorrhoids: from basic pathophysiology to clinical management","volume":"18","author":"Lohsiriwat","year":"2012","journal-title":"World J Gastroenterol"},{"key":"B37","doi-asserted-by":"publisher","first-page":"9245","DOI":"10.3748\/wjg.v21.i31.9245","article-title":"Treatment of hemorrhoids: a coloproctologist's view","volume":"21","author":"Lohsiriwat","year":"2015","journal-title":"World J Gastroenterol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"650","DOI":"10.1111\/codi.14975","article-title":"European society of coloproctology: guideline for haemorrhoidal disease","volume":"22","author":"van Tol","year":"2020","journal-title":"Colorectal Dis"},{"key":"B39","doi-asserted-by":"publisher","first-page":"146","DOI":"10.3393\/ac.2020.01011.0144","article-title":"Hemorrhoidectomy versus rubber band ligation in grade III hemorrhoidal disease: a large retrospective cohort study with long-term follow-up","volume":"38","author":"Dekker","year":"2022","journal-title":"Ann Coloproctol"},{"key":"B40","doi-asserted-by":"publisher","first-page":"857","DOI":"10.1007\/s00384-021-03895-w","article-title":"Analysis of risk factors for delayed bleeding after semi-closed hemorrhoidectomy","volume":"36","author":"Jeong","year":"2021","journal-title":"Int J Colorectal Dis"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1755971\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T05:44:08Z","timestamp":1774417448000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1755971\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,25]]},"references-count":40,"alternative-id":["10.3389\/fmed.2026.1755971"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1755971","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,25]]},"article-number":"1755971"}}