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Rubber band ligation versus coagulation for the treatment of haemorrhoids: a meta-analysis of randomised controlled trials
  1. Zhihao Ding1,
  2. Ji Xuan1,
  3. Guoxing Tang1,
  4. Shaopei Shi1,
  5. Xuejun Liang2,
  6. Qin An1,
  7. Fangyu Wang1
  1. 1Department of Gastroenterology and Hepatology, Jinling College of Nanjing Medical University, Nanjing, Jiangsu, China
  2. 2Department of Gastroenterology, Lishui City People's Hospital, Lishui, Zhejiang, China
  1. Correspondence to Dr Fangyu Wang, Nanjing Jinling Hospital, Nanjing, Jiangsu, China; wangfy65{at}


Non-surgical therapies have the advantage of lower postoperative pain and complication rates compared with surgical therapies. Rubber band ligation and coagulation are two kinds of non-surgical therapies. The aim of this study is to compare the clinical outcomes of rubber band ligation and coagulation. A systematic review was conducted to identify randomised clinical trials that compare rubber band ligation and coagulation treatments for haemorrhoids. PubMed and Web of Science were searched, from inception to April 30th,2022. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Fifty-nine studies were identified. Nine trials met the inclusion criteria. All trials were of moderate methodological quality. No significant difference was found between rubber band ligation and coagulation in terms of efficacy rate, postoperative prolapse rate, recurrence rate and postoperative urine retention rate after treatment. Patients undergoing rubber band ligation had higher postoperative pain rate and lower postoperative bleeding rate than patients undergoing coagulation. The subgroup analysis showed that there was no significant difference between rubber band ligation and infrared coagulation or non-infrared coagulation in terms of efficacy rate, postoperative bleeding and postoperative urine retention rate after treatment. Patients undergoing rubber band ligation had a higher postoperative pain rate than patients undergoing infrared coagulation or non-infrared coagulation. We believe that coagulation for haemorrhoids still has a good future. PROSPERO registration number CRD42022311281.

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  • Contributors ZD designed the review and wrote the article, JX participated in risk of bias assessment and statistical analysis, GT selected articles and extracted data, SS resolved the discrepancies and extracted data, XL reached a consensus, QA selected articles, FW reviewed and corrected the article. All authors read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.