Evaluation of Rubber band ligation technique for Internal Haemorrhoids
Keywords:
Hemorrhoids, 2nd degree hemorrhoids, Rubber band ligation technique
Abstract
Introduction: Hemorrhoids are masses or clumps or “cushions” of tissues consisting of muscle and elastic fibres with enlarged, bulging blood vessels and surrounding supporting tissues present in the anal canal of an individual suffering from the disease. It is one of the common reasons for surgical OPD visit. In this study we tried to find out effectiveness of Ring band ligation technique 1st degree, 2nd degree & some of the 3rd degree hemorrhoids.
Methods: All the patients coming to surgical OPD of tertiary care teaching hospital from June 2012 to December 2013 and diagnosed as a case of Hemorrhoids were included in study. Proctoscopic examination found to have first-, second-, and non-bulky, non edematous third-degree haemorrhoids were included for band ligation.
Results: Out of total patients 202 were males and 145 were females. Bleeding per rectum (52%), discomfort during defecation (58%) and constipation (47%) were most common symptoms. Most common post-ligation/residual symptoms were bleeding (32 %), pain & discomfort (29.4 %) & constipation (21 %).70 % of patients are cured and 14 % have shown significant improvement.
Conclusion: Rubber band ligation as first line treatment for 2nd degree lesion, however for 3rd degree lesion Open hemorrhoidectomy is always better.
Downloads
Download data is not yet available.
References
1. Liebach JR, Cerda JJ: Hemorrhoids:modern treatment methods. Hosp Med. 1991: 27(8),53-68.
2. Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012;27:215–220.
3. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology. 1990;98:380–386.
4. Hemmorrhoids. National Digestive Diseases Information clearing house (NDDIC). A Service of the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK).Available from URL: httpdigestive.niddk.nin.gov/ddiseases/pubs/hemmorrhoi ds/
5. Salvati EP. Nonoperative management of hemorrhoids: evolution of the office management of hemorrhoids. Dis Colon Rectum. 1999;42:989–993.
6. Morgado PJ, Suárez JA, Gómez LG, Morgado PJ. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum. 1988;31:474–480.
7. Goenka MK, Kochhar R, Nagi B, Mehta SK. Rectosigmoid varices and other mucosal changes in patients with portal hypertension. Am J Gastroenterol. 1991;86:1185–1189.
8. Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18:2009–2017.
9. American society of colon and rectal surgeons Practice parameters for the treatment of haemorrhoids. Dis Colon Rectum. 1993;36:1118–1120. doi: 10.1007/BF02047288.
10. Barron J. Office ligation treatment of hemorrhoids. Dis Colon Rectum. 1963;6:109–113. doi: 10.1007/BF02633461. 11. Sato SG, Novell JR, Khowry G, Winslet MC, Lewis
AA. Long term results of large dose, single-session phenol injection sclerotherapy for hemorrhoids. Dis Colon Rectum. 1993;36:958–691. doi: 10.1007/BF02050633.
12. Leicesters RS, Nicholls RJ, Chair M, et al. Infra red coagulation: a new treatment for hemorrhoids. Dis Colon Rectum. 1981;24:602–605. doi: 10.1007/BF02605755.
13. Lord PH. A day case procedure for the cure of third degree hemorrhoids. Br J Surg. 1969;56:747–749. doi: 10.1002/bjs.1800561013.
14. Buls JG, Goldberg SM. Modern management of hemorrhoids. Surg Clin North Am. 1978;58:469.
15. Hodgson WJ, Morgan J. Ambulatory haemorrhoidectomy with CO2 laser. Dis Colon Rectum.1995;38:1265. doi: 10.1007/BF02049150.
16. Moringa K, Hasuda K, Ideda T, et al. A novel therapy for internal hemorrhoids: ligation of the haemorrhoidal artery with a newly devised instrufment (Moricorn) in conjunction with a Doppler flow meter.Am J Gastroenterol. 1995;90:610.
17. Ferguson JA, Mazier WP, Ganchrow MI, Friend WG. The closed technique of hemorrhoidectomy. Surgery. 1971;70:480.
18. Reis Neto JA, Quilici FA, Cordeiro F, Reisjunior JA. Open versus semi open hemorrhoidectomy: a random trial. Int Sug. 1992;77:84.
19. Rowsell M, Bello M, Hemingway DM. Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355:779. doi: 10.1016/S0140- 6736(99)06122-X.
20. 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(11):786–788. doi:10.1002/bjs.1800671108.
21. 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(24):1265–8.
22. Hosch SB, Knoefel WT, et al (1998) Surgical treatment of piles, prospective randomized study of Parks vs Milligan Morgan hemorrhoidectomy. Dis Colon Rectum Feb 159–164.
23. Sohn N, Aronoff JS, Cohen FS, et al. Transanal haemorrhoidal dearterialization is an alternative to operative haemorroidectomy. Am J Surg. 2001;182(2001):515–519. doi: 10.1016/S0002- 9610(01)00759-0.
24. Steinberg DA, Liegois HJ, Willaims A. Long term review of the results of rubber band ligation of haemorrhoids. BJS. 1975;62:144–146. doi: 10.1002/bjs.1800620216.
25. O’Regan PJ. Disposable device and a minimally invasive technique for rubber band ligation of haemorrhoids. Dis Colon Rectum. 1999;42(5):683–685. doi: 10.1007/BF02234151.
26. 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(4):247–249. doi: 10.1002/bjs.1800680409.
27. Vellacott KD, Hardcastle JD. Is continued anal dilatation necessary after a Lord’s procedure for haemorrhoids. BJS. 1980;67:658–659. doi: 10.1002/bjs.1800670918.
28. Broader JH, Gunn IF, Williams A. Evaluation of a bulk forming evacuant in the management of haemorrhoids. BJS. 1974;61:142–144. doi: 10.1002/bjs.1800610218.
29. Bennett RC, Friedman MHW, Goligher JC. Late results of haemorrhoidectomy by ligation and excision. BMJ. 1963;2:216–219. doi: 10.1136/bmj.2.5
2. Riss S, Weiser FA, Schwameis K, Riss T, Mittlböck M, Steiner G, Stift A. The prevalence of hemorrhoids in adults. Int J Colorectal Dis. 2012;27:215–220.
3. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterology. 1990;98:380–386.
4. Hemmorrhoids. National Digestive Diseases Information clearing house (NDDIC). A Service of the National Institute of Diabetes and Digestive and Kidney
Diseases (NIDDK).Available from URL: httpdigestive.niddk.nin.gov/ddiseases/pubs/hemmorrhoi ds/
5. Salvati EP. Nonoperative management of hemorrhoids: evolution of the office management of hemorrhoids. Dis Colon Rectum. 1999;42:989–993.
6. Morgado PJ, Suárez JA, Gómez LG, Morgado PJ. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum. 1988;31:474–480.
7. Goenka MK, Kochhar R, Nagi B, Mehta SK. Rectosigmoid varices and other mucosal changes in patients with portal hypertension. Am J Gastroenterol. 1991;86:1185–1189.
8. Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol. 2012;18:2009–2017.
9. American society of colon and rectal surgeons Practice parameters for the treatment of haemorrhoids. Dis Colon Rectum. 1993;36:1118–1120. doi: 10.1007/BF02047288.
10. Barron J. Office ligation treatment of hemorrhoids. Dis Colon Rectum. 1963;6:109–113. doi: 10.1007/BF02633461. 11. Sato SG, Novell JR, Khowry G, Winslet MC, Lewis
AA. Long term results of large dose, single-session phenol injection sclerotherapy for hemorrhoids. Dis Colon Rectum. 1993;36:958–691. doi: 10.1007/BF02050633.
12. Leicesters RS, Nicholls RJ, Chair M, et al. Infra red coagulation: a new treatment for hemorrhoids. Dis Colon Rectum. 1981;24:602–605. doi: 10.1007/BF02605755.
13. Lord PH. A day case procedure for the cure of third degree hemorrhoids. Br J Surg. 1969;56:747–749. doi: 10.1002/bjs.1800561013.
14. Buls JG, Goldberg SM. Modern management of hemorrhoids. Surg Clin North Am. 1978;58:469.
15. Hodgson WJ, Morgan J. Ambulatory haemorrhoidectomy with CO2 laser. Dis Colon Rectum.1995;38:1265. doi: 10.1007/BF02049150.
16. Moringa K, Hasuda K, Ideda T, et al. A novel therapy for internal hemorrhoids: ligation of the haemorrhoidal artery with a newly devised instrufment (Moricorn) in conjunction with a Doppler flow meter.Am J Gastroenterol. 1995;90:610.
17. Ferguson JA, Mazier WP, Ganchrow MI, Friend WG. The closed technique of hemorrhoidectomy. Surgery. 1971;70:480.
18. Reis Neto JA, Quilici FA, Cordeiro F, Reisjunior JA. Open versus semi open hemorrhoidectomy: a random trial. Int Sug. 1992;77:84.
19. Rowsell M, Bello M, Hemingway DM. Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355:779. doi: 10.1016/S0140- 6736(99)06122-X.
20. 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(11):786–788. doi:10.1002/bjs.1800671108.
21. 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(24):1265–8.
22. Hosch SB, Knoefel WT, et al (1998) Surgical treatment of piles, prospective randomized study of Parks vs Milligan Morgan hemorrhoidectomy. Dis Colon Rectum Feb 159–164.
23. Sohn N, Aronoff JS, Cohen FS, et al. Transanal haemorrhoidal dearterialization is an alternative to operative haemorroidectomy. Am J Surg. 2001;182(2001):515–519. doi: 10.1016/S0002- 9610(01)00759-0.
24. Steinberg DA, Liegois HJ, Willaims A. Long term review of the results of rubber band ligation of haemorrhoids. BJS. 1975;62:144–146. doi: 10.1002/bjs.1800620216.
25. O’Regan PJ. Disposable device and a minimally invasive technique for rubber band ligation of haemorrhoids. Dis Colon Rectum. 1999;42(5):683–685. doi: 10.1007/BF02234151.
26. 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(4):247–249. doi: 10.1002/bjs.1800680409.
27. Vellacott KD, Hardcastle JD. Is continued anal dilatation necessary after a Lord’s procedure for haemorrhoids. BJS. 1980;67:658–659. doi: 10.1002/bjs.1800670918.
28. Broader JH, Gunn IF, Williams A. Evaluation of a bulk forming evacuant in the management of haemorrhoids. BJS. 1974;61:142–144. doi: 10.1002/bjs.1800610218.
29. Bennett RC, Friedman MHW, Goligher JC. Late results of haemorrhoidectomy by ligation and excision. BMJ. 1963;2:216–219. doi: 10.1136/bmj.2.5
CITATION
DOI: 10.17511/ijmrr.2014.i06.16
Published: 2014-12-31
How to Cite
1.
Saxena A, K Parate S. Evaluation of Rubber band ligation technique for Internal Haemorrhoids. Int J Med Res Rev [Internet]. 2014Dec.31 [cited 2024Dec.23];2(6):604-9. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/165
Section
Original Article
OAI - Open Archives Initiative
