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Comparative Study between Classical Hemorrhoidectomy and Rubber Band Ligation in the Treatment of Hemorrhoid

Iraqi Postgraduate Medical Journal, 2022, Volume 21, Issue 3, Pages 333-393
10.52573/ipmj.2020.175815

Abstract

BACKGROUND:
Hemorrhoids are quite common disease affecting the anus and may require traditional surgical treatment, but the rubber band ligation (RBL) emerged as a less invasive and effective method of treatment.
AIM:
This study was performed to assess the efficacy of rubber band ligation as an option in the treatment of hemorrhoid in comparison to classical hemorrhoidectomy using (pain, bleeding, return to daily activities and recurrence) as parameters. 
METHOD:
A prospective study was conducted from January 2018 till July 2019 at Mosul teaching center, it compares the results of  RBL and classical hemorrhoidectomy. It includes 100 patients having grade two and three hemorrhoid who were selected randomly and divided into 2 groups of 50 patients each (hemorrhoidectomy group and RBL group). Patients with other lesions such as fissures and fistulae were excluded from the study. All data were recorded and subsequently analyzed.
RESULTS:
From 100 patient, the 50 patient whom were treated by rubber band ligation had less pain , less bleeding, early mobilization, and more cost effective as they were treated as an outpatient basis compared to hemorrhoidectomy group; however, the recurrence rate (after less than 6 months) were much higher in RBL group compared to Hemorrhoidectomy group.
CONCLUSION:
RBL can be used effectively in the treatment of grade 2 and 3 hemorrhoid as it has less postoperative complications (less pain and less bleeding) and should be considered as first line in patients who are unfit for surgery as it is done as an outpatient basis. However, patients may need multiple sessions (more recurrence rate) especially those with multiple hemorrhoids and with grade 3 hemorrhoid.
 
 
Keywords:

  1. http://mediwikis.com/wiki/index.php/Haemorrhoidectomy_Masterscript. [Online]. [cited 2018 7 23.
  2. Angelo Pezzullo ENDP. Rubber band ligation of hemorrhoids. 5-year follow-up. Giornale di chirurgia. 2000:253-56.
  3. Brunicardi FC, Andersen DK, Billiar TR, Dunn DL, Hunter JG, Matthews JB, et al. Schwartz's principles of surgery. In. U.S.A.: McGraw-hill companys, Inc.; 2010: 2017-18.
  4. Cheng FC SDOG. The treatment of second degree haemorrhoids by injection, rubber band ligation maximal anal dilatation, and haemorrhoidectomy: a prospective clinical trial. Aust N Z J Surg. 1981: 458-62.
  5. LE S. Hemorrhoids. A review of current techniques and management. Gastroenterol Clin North Am. 1987: 79-91.
  6. M Rowsell MBDMH. Circumferential mucosectomy (stapled haemorrhoidectomy) versus. THE LANCET. 2000;355.
  7. MacRae HM MR. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum. 1995: 687-94.
  8. Pissiotis VAKGJSCA. Rubber Band Ligation of Symptomatic Internal Hemorrhoids: Results of 500 Cases. Digestive Surgery. 2000;17.
  9. Thomson RJLWHF. A prospective study of outcome from rubber band ligation of piles. Colorectal Disease. 2006 :145-48.

10. THOMSON WHF. The nature of haemorrhoids. British Journal of Surgery. doi:10.1002/bjs.1800620710. 1975;62:542-52.

11. Vassilios A, Kvsgpc. Rubber band ligation of symptomatic internal hemorrhoids. Digestive Surgery. 2000:71-76.

12. Murie JA, Mackenzie I, Sim AJ Comparison of rubber band ligation and hemorrhoidectomy for second and third degree haemorrhoids: a prospective clinical trial. BJS 1980; 67:786–88.

13. Konings M, Debets JM, Baeten CG Rubber band ligation of hemorrhoids: symptoms almost gone after 6 weeks but many patients need retreatment in the long run.Ned Tijdschr Geneeskd 1999;143:1265–68.

14. Hosch SB, Knoefel WT, et al Surgical treatment of piles, prospective randomized study of Parks vs Milligan Morgan hemorrhoidectomy. Dis Colon Rectum 1998; 159–64.

15. Sohn N, Aronoff JS, Cohen FS et al Transanal haemorrhoidal dearterialization is an alternative to operative haemorroidectomy. Am J Surg 2001;182:515–19.

16. Murie JA, Sim AJ, Mackenzie I The importance of pain, pruritis and soiling as symptoms of haemorrhoids and their response to haemorrhoidectomy or rubber band ligation. BJS 1981; 68:247–49.

17. Caro A, Olona C, Vicente V, Goncalves C, Jimenez A  Grade 3 haemorrhoidal treatment: rubber band ligation or haemorrhoidectomy—a prospective study. Ambul Surg 2010;16.

18. Murie JA, Sim AJ, Mackenzie I  Rubber band ligation versus haemorrhoidectomy for prolapsing haemorrhoids: a long term prospective clinical trial. BJS 1982;69:536–38.

19. Steinberg DA, Liegois HJ, Willaims A Long term review of the results of rubber band ligation of haemorrhoids. BJS 1975; 62:144–46.

20. Panda AP, Laughton JM, Elder JB, Gillespie IE Treatment of haemorrhoids by rubber band ligation. Digestion 1975;12:85-91.

21. Mlakar, Bostjan & Kosorok, Pavle.. Flavonoids to reduce bleeding and pain after stapled hemorrhoidopexy: A randomized controlled trial. Wiener klinische Wochenschrift. 2005;117:558-60. 10.1007/s00508-005-0420-21

22. Bat L, Melzer E, Koler M, Dreznick Z, Shemesh E. Complications of rubber band ligation of symptomatic internal hemorrhoids. Dis Colon Rectum. 1993;36:287–90.

23. Odelowo OO, Mekasha G, Johnson MA. Massive life-threatening lower gastrointestinal hemorrhage following hemorrhoidal rubber band ligation. J Natl Med Assoc. 2002;94:1089–92.

24. Beattie GC, Rao MM, Campbell WJ. Secondary haemorrhage after rubber band ligation of haemorrhoids in patients taking clopidogrel--a cautionary note. Ulster Med J. 2004;73:139-41.

25. Parker R, Gul R, Bucknall V, Bowley D, Karandikar S. Double jeopardy: pyogenic liver abscess and massive secondary rectal haemorrhage after rubber band ligation of haemorrhoids. Colorectal Dis. 2011;13:e184.

26. Patel S, Shahzad G, Rizvon K, Subramani K, Viswanathan P, Mustacchia P. Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin. World J Clin Cases. 2014;2:86–89.

27. Tutino R1, Salamone G2, De Marco P2, Cocorullo G3, Gulotta G3.Outpatient Treatment of Hemorrhoidal Disease: The Alternative Way to Treat Hemorrhoidal Disease in a Simple, Safe and Effective Manner. Rev Recent Clin Trials. 2020 Mar 5. doi: 10.2174/1574887115666200305150029. [Epub ahead of print]

28. Sha HL, Roslani AC, Poh KS. Evaluating the Ability of the Sodergren Score to Guide the Management of Internal Haemorrhoidal Disease. Colorectal Dis. 2020 Apr 26. doi: 10.1111/codi.15091. [Epub ahead of print]

29. Mushtaq A. Gagloo & S. Wardul Hijaz & S. Aijaz Nasir ,Arjmand Reyaz & I. H. Bakshi & Nisar A. Chowdary & Sameer A. Naqash & Banday M. Sharief Comparative Study of Hemorrhoidectomy and Rubber Band Ligation in Treatment of Second and Third Degree Hemorrhoids in Kashmir Indian J Surg 2013;75:356–60.

30. D. F. Altomare,A. Picciariello ,G. Pecorella  et al .Surgical management of haemorrhoids: an Italian survey of over 32 000 patients over 17 years.The Italian Haemorrhoid Survey Group.2018 colorectal disease (20):12

31. S. R. Brown1 • A. Watson. Comments to ‘Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids’.Techniques in coloproctology 20:659-61.

32. Wechter, D.G. & Luna, G.K. Dis Colon Rectum 1987;30: 137. https://doi.org/10.1007/BF02554954

33. Russell TR, Donohue JH. Hemorrhoidal banding. A warning. Dis Colon Rectum. 1985;28:291–293.

34. Quevedo-Bonilla G, Farkas AM, Abcarian H, Hambrick E, Orsay CP. Septic complications of hemorrhoidal banding. Arch Surg. 1988;123:650–51.

35. O’Hara VS. Fatal clostridial infection following hemorrhoidal banding. Dis Colon Rectum. 1980;23:570–71.

36. Sim HL, Tan KY, Poon PL, Cheng A, Mak K. Life-threatening perineal sepsis after rubber band ligation of haemorrhoids. Tech Coloproctol. 2009;13:161–64.

 

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