Modified Sclerobanding ( Rubber Band Ligation combined with 3% Polidocanol Foam Sclerotherapy ) for the Treatment of Second and Third-Degree Hemorrhoidal Disease: clinical efficacy and safety evaluation—a retrospective study

Abstract Purpose: Sclerobanding (SB) is a novel technique that merges rubber band ligation with 3% polidocanol foam sclerotherapy for hemorrhoidal disease (HD) treatment. This study assessed the effectiveness and safety of Modified Sclerobanding (mSB) for second- and third-degree HD. Methods:Consecutive patients with grade II or III internal hemorrhoids underwent RBL treatment from January 2021 to December 2021, followed by mSB from January 2022 to December 2022 at Ningbo Medical Center of Lihuili Hospital. Primary outcomes, such as postoperative treatment failure rate and delayed bleeding (DB) incidence, and secondary outcomes, including postoperative complications (pain, swelling, anal edema, bleeding grade variation), were reviewed retrospectively. Long-term follow-up outcomes, including the Hemorrhoidal Disease Symptom Score (HDSS), Short Health Scale adapted for Hemorrhoidal Disease (SHSHD), and Patient Satisfaction (PS), were also assessed. Results: Among 307 enrolled patients, 162 received mSB and 125 underwent traditional RBL. Baseline characteristics showed no significant differences between groups, except for anticoagulant history and hospital stay length (P < 0.05). No delayed major bleeding occurred in the mSB group, contrasting with 5 cases in the RBL group. The mSB group exhibited a lower recurrence rate (6.8% vs. 17.0%) and treatment failure rate (6.8% vs. 18.6%) compared to the RBL group (P < 0.05). While postoperative complications did not significantly differ between groups, bleeding improvement on the 7th day was superior in the mSB group (P < 0.05). Long-term outcomes showed no significant differences in HDSS, SHS-HD, and PS scores. Conclusion: The mSB procedure combines the advantages of sclerosant injection therapy and RBL, reducing the number of ligation sessions while lowering the risk of DB and decreasing the treatment failure rate. The modified injection method does not increase the incidence of postoperative complications.