Endoscopic Band Ligation With Sclerotherapy Versus Milligan-Morgan Hemorrhoidectomy for the Treatment of Mixed Hemorrhoids

BACKGROUND AND AIMS: To compare the clinical efficacy of endoscopic band ligation with sclerotherapy (EBS) with that of Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of mixed hemorrhoids. METHODS: This study was a retrospective, single-center investigation conducted at the First Hospital of Yangtze University. From September 2022 to March 2023, 46 patients who underwent EBS for mixed hemorrhoids were selected in an observation group, whereas 32 patients who underwent MMH for mixed hemorrhoids were allocated to a control group. Surgical-related parameters and adverse events were compared between the 2 groups, and the relationship between the number of endoscopic bands used and pain levels was analyzed. RESULTS: The observation group demonstrated significantly shorter surgical and hospitalization durations than the control group (P < 0.05). Furthermore, the 2 groups showed decreased postoperative visual analog scale scores, with the observation group exhibiting consistently lower scores at 24 hours, 48 hours, and 1 week postoperatively (P < 0.05). Additionally, visual analog scale scores in the observation group at 4 hour postsurgery were correlated with the number of endoscopic ligation bands applied (R-2 = 0.1253; P = 0.0158). No significant differences in postoperative anal swelling, overall efficacy, or patient satisfaction were observed between the 2 groups (all P > 0.05). However, the observation group experienced significantly less intraoperative (0% vs 84.4%; P = 0.000) and postoperative bleeding (6.5% vs 34.4%; P = 0.002) and a lower postoperative infection rate (0% vs 9.4%; P = 0.034) than the control group. CONCLUSION: EBS provides clinical efficacy comparable with that of MMH in the treatment of mixed hemorrhoids. Moreover, the EBS approach is a potentially less invasive and shorter surgical procedure with relatively reduced hospitalization time, lower complication risk, and faster recovery.