P2465 - Hemorrhoidal Banding: A Retrospective Study of Effectiveness in a Community Setting

Nikhil Bhargava, DO¹, Paul Kozak, DO¹, Vijay Kata, MD^2
1Riverside Medical Group, Kankakee, IL; ²Riverside Medical Center, Kankakee, IL

Introduction: Hemorrhoids are a common condition affecting nearly half of Americans over age 50. Rubber band ligation (RBL) has emerged as one of the most widely used non-surgical interventions for symptomatic hemorrhoids. The success rate of hemorrhoidal banding can vary on several factors including the skill of the provider, severity of the hemorrhoids, and the setting in which the procedure is performed. Manufacturers typically report high success rates, even higher than 95% in some studies. These rates are based on controlled environments and ideal conditions, which may not reflect what is happening within the community. This study aims to compare
the success rates of hemorrhoidal banding procedures performed at a community healthcare center with those reported by the manufacturer of the banding device. This study seeks to provide a more realistic understanding of RBL efficacy in a community setting.

Methods: This is a retrospective study conducted at a community outpatient GI office, examining the medical records of patient who underwent RBL for hemorrhoidal disease. The study period spanned from January 2016 to December 2018. A total of 195 patients were included in the analysis. The analysis compared success rate of RBL procedures in the community with success rates reported by the manufacturer. 24 patients did not follow up after their banding, and thus it is unknown if their symptoms recurred. A two-proportion z-test was conducted to compare the two groups.

Results: The demographics for the study are listed in Table 1. The success rate of RBL at the community healthcare center, defined as resolution of patient’s symptoms after completion of RBL therapy was 57%, compared to the manufacturer’s study of 95%. The z-test for difference in proportions yielded a p-value of < 0.0001. Even if the patients lost to follow up were assumed to be successful, the success rate was measured at 63%, which still yields a p value of < 0.0001 (Table 2).

Discussion: This study suggests that the success rate for RBL of hemorrhoidal disease in the community setting may be lower than the rates reported by the manufacture. This highlights the need to consider real-world data when evaluating medical procedures when implementing in a clinical practice. Potential reasons for discrepancies could include differences in patient population, selection bias with patients with more severe hemorrhoids were more likely to be treated, and provider experience with RBL.


Disclosures:


Nikhil Bhargava, DO¹, Paul Kozak, DO¹, Vijay Kata, MD². P2465 - Hemorrhoidal Banding: A Retrospective Study of Effectiveness in a Community Setting, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.