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Haemorrhoidal artery ligation led to fewer recurrences of haemorrhoids after one year than rubber band ligation but with more early pain; and is unlikely to be cost-effective for the NHS.

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Steven Brown 1, Jim Tiernan 2, Katie Biggs 3,*, Daniel Hind 3, Neil Shephard 3, Mike Bradburn 3, Allan Wailoo 3, Abualbishr Alshreef 3, Lizzie Swaby 3, Angus Watson 4, Simon Radley 5, Oliver Jones 6, Paul Skaife 7, Anil Agarwal 8, Pasquale Giordano 9, Marc Lamah 10, Mark Cartmell 11, Justin Davies 12, Omar Faiz 13, Karen Nugent 14, Andrew Clarke 15, Angus MacDonald 16, Phillip Conaghan 17, Paul Ziprin 18, Rohit Makhija 19

1 Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
2 Leeds Teaching Hospitals NHS Trust, Leeds, UK
3 School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
4 NHS Highland, Inverness, UK
5 University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
6 Oxford University Hospitals NHS Trust, Oxford, UK
7 Aintree University Hospital NHS Foundation Trust, Liverpool, UK
8 North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
9 Barts Health NHS Trust, London, UK
10 Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
11 Northern Devon Healthcare NHS Trust, Devon, UK
12 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
13 North West London Hospitals NHS Trust, London, UK
14 University Hospital Southampton NHS Foundation Trust, Southampton, UK
15 Poole Hospital NHS Foundation Trust, Poole, UK
16 NHS Lanarkshire, Airdrie, UK
17 Royal Berkshire NHS Foundation Trust, Reading, UK
18 Imperial College Healthcare NHS Trust, London, UK
19 Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough, UK
* Corresponding author Email: c.e.biggs@sheffield.ac.uk

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