Rubber band ligation or shaobei injection for the endoscopic treatment of symptomatic hemorrhoids? A retrospective study

Background It is unknown whether Shaobei injection is superior to band ligation for endoscopic symptomatic hemorrhoid treatment. We compared the clinical efficacy, safety, and health economics of the two techniques. Aims This study aims to compare the efficacy, safety and health economics of endoscopic injection of Shaobei and endoscopic ligation in the treatment of grade I-IV symptomatic hemorrhoids. Methods This retrospective cohort study collected clinical data from 413 patients with grade I-IV symptomatic hemorrhoids treated with endoscopy between January 2019 and March 2023. Recurrence rate, postoperative complications, hospitalization costs, hospitalization time, postoperative quality of life (QoL), and postoperative satisfaction were compared between Shaobei injection (treatment group; n = 79) and band ligation (control group; n = 334) groups within 3 months postoperatively. Results Before propensity score matching (PSM), the basic characteristics of patients significantly differed between groups (P < 0.05); no differences existed after PSM (Shaobei injection: n = 53; band ligation: n = 83). Recurrence rates did not differ between groups at 3 months postoperatively (P = 0.439). Postoperative symptom grading did not differ between groups (all P > 0.05) but was improved from baseline (all P < 0.001). However, the injection group experienced significantly less pain than the band ligation group on postoperative days 1 (P < 0.001) and 7 (P = 0.003). Significantly lower incidences were observed in the injection than in the ligation group for postoperative anal distention within 1 day (P < 0.001) and complications within 7 days (P < 0.001). No differences between groups were observed for other variables. Conclusion Endoscopic Shaobei injection is effective and safe for treating grade I-IV symptomatic hemorrhoids, with less postoperative discomfort and fewer postoperative complications than with band ligation.