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Combined colonoscopy and three-quadrant hemorrhoidal ligation: 500 consecutive cases.

Kurt G Davis¹, Arie E Pelta, David N Armstrong

¹Georgia Colon & Rectal Surgical Clinic, Atlanta, GA 30342, USA.

Diseases of the Colon and Rectum

|August 1, 2007

Summary

Combining colonoscopy with hemorrhoidal ligation offers a safe and effective treatment for internal hemorrhoids. This dual procedure resolves symptoms in over 93% of patients, improving efficiency.

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Area of Science:

Gastroenterology
Colorectal Surgery

Background:

Symptomatic internal hemorrhoidal disease often requires intervention.
Patients needing colonoscopy may also have concurrent hemorrhoidal issues.

Purpose of the Study:

To evaluate the safety and efficacy of combining outpatient colonoscopy with simultaneous three-quadrant hemorrhoidal ligation.
To assess the outcomes of this combined procedure for internal hemorrhoids.

Main Methods:

A four-year analysis of 500 patients undergoing combined colonoscopy and synchronous three-quadrant hemorrhoidal ligation.
Procedures performed under moderate sedation, followed by ligation using specialized instruments.
Outcomes tracked, including repeat ligation, surgical intervention, and 30-day readmission rates.

Main Results:

93.4% of patients experienced complete symptom resolution.
Only 6.6% required repeat ligation, and 2.2% needed surgical hemorrhoidectomy.
No admissions for bleeding, pelvic sepsis, or emergent surgical intervention were reported.

Conclusions:

Simultaneous colonoscopy and three-quadrant hemorrhoidal ligation is a safe and effective treatment.
The combined procedure offers convenience and efficient use of resources for physicians and patients.