title: Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids.
abstract: OBJECTIVE
  To assess the long-term outcome of endoscopic hemorrhoid ligation (EHL) for the treatment of symptomatic internal hemorrhoids.
  
  
  METHODS
  A total of 759 consecutive patients (415 males and 344 females) were enrolled. Clinical presentations were rectal bleeding (593 patients) and mucosal prolapse (166 patients). All patients received EHL at outpatient clinics. Hemorrhoid severity was classified by Goligher's grading. The mean follow-up period was 55.4 mo (range, 45-92 mo).
  
  
  RESULTS
  The number of band ligations averaged 2.35 in the first session for bleeding and 2.69 for prolapsed patients. Bleeding was controlled in 587 (98.0%) patients, while prolapse was reduced in 137 (82.5%) patients. After treatment, 93 patients experienced anal pain and 48 patients had mild bleeding. Patient subjective satisfaction was 93.6%. Repeat treatment or surgery was performed if symptoms were not relieved in the first session. In the bleeding group, the recurrence rate was 3.7% (22 patients) at 1 year, and 6.6% and 13.0% at 2 and 5 years. In the prolapsed group, the recurrence rate was 3.0%, 9.6% and 16.9% at 1, 2 and 5 years, respectively.
  
  
  CONCLUSIONS
  EHL is an easy and well-tolerated procedure for the treatment of symptomatic internal hemorrhoids, with good long-term results.
authors.affiliation: Department of Gastroenterology and Hepatology, Lin-Kou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333, Taiwan, China. doctorsu@adm.cgmh.org.tw
authors.forename: Ming-Yao
authors.initials: MY
authors.lastname: Su
authors.forename: Cheng-Tang
authors.initials: CT
authors.lastname: Chiu
authors.forename: Wei-Pin
authors.initials: WP
authors.lastname: Lin
authors.forename: Chen-Ming
authors.initials: CM
authors.lastname: Hsu
authors.forename: Pang-Chi
authors.initials: PC
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology; D006484:Hemorrhoids / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult