Hasil penelitian case report yang disusun oleh dr. Ahmad Fariz Malvi Zamzam Zein, SpPD, MM, FINASIM, FACP, dr. Ahmad Ichwan Luthfi, dr. Galang Prasetyo Adi, dan dr. Lusi Pratiwi telah dipublikasikan dalam The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol. 25, No, 2 (2) dengan judul Endoscopic band ligation for treatment of bleeding internal hemorrhoids in primary referral hospital: evidence-based case report.

Penelitian ini menjelaskan mengenai efektivitas dan keamanan endoskopi ligasi dalam mengendalikan perdarahan dan menurunkan derajat hemoroid pada pasien dengan hemoroid internal berdarah derajat III.

ABSTRACT
Background and Aim. It is preferred that the management of internal hemorrhoids necessitates minimally invasive modality, high efficacy, less complication and feasibility in hospital with availability of endoscopy. This study aimed to evaluate the efficacy and safety of endoscopic band ligation (EBL) for bleeding grade III internal hemorrhoids in an evidence-based case report.

Methods. A 50-year-old male patient with hematoschezia and anal pain was diagnosed as grade III bleeding internal hemorrhoid. Non-surgical management was preferred. The physician urged to provide the evidence regarding the safety and efficacy of endoscopic band ligation, compared to other modalities. A search was conducted on PubMed and Cochrane databases based on clinical query, with keywords “endoscopic band ligation AND internal hemorrhoids”. The inclusion criteria were meta-analysis, systematic review and randomized clinical trial, and written in English. The critical appraisal was performed for validity, importance and applicability.

Results. Of 18 studies, only 2 studies suited the criteria. Compared to bipolar electrocoagulation (BPEC), EBL had significantly higher success rate in controlling bleeding and reducing the grade of hemorrhoids. In comparison with band ligation with rigid proctoscope (BL-RP), EBL was associated with higher success rate, lesser treatment sessions and earlier symptom control. Mild complications and symptomatic recurrence were comparable among EBL, BPEC and BL-RP.

Conclusion. Endoscopic band ligation is effective and safe for bleeding grade III internal hemorrhoids. It is feasible procedure in primary referral hospital.

Keyword: bleeding internal hemorrhoids, efficacy, endoscopic band ligation, safety

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The INA-JGHE Vol.25, No. 2 (2024)