Experience of rubber band ligation for haemorrhoidal disease

ABSTRACT

To assess symptomatic relief in haemorrhoidal disease using rubber band ligation. Surgical unit, Hayatabad Medical Complex, Peshawar from July 2007 to June 2009. All patients presenting with rectal bleeding or prolase underwent proctoscopy to determine the cause of bleeding. Only patients with 1[st], 2[nd] and 3[rd] degree haemorrhoids [bleeding and prolapse] were selected for the study and they underwent rubber band ligation in two sessions, 6 weeks apart. Patients were followed in the OPD at 3 months and one year when their subjective and objective symptoms were noted followed by rectal examination and proctoscopy. Therapeutic response was assessed by symptomatic improvement in bleeding and prolapse of hemorrhoids and any complications. A total of 105 patients underwent rubber band ligation. There were 65[62%] males and 40[38%] females with a male to female ratio of 1.61. Age of the patients ranged from 21-65 years [ +/- 2.4SD]. Twenty three [21.9%] patients had 1[st] degree, 50[47.6%] had 2[nd] degree and 32[30.5%] had 3[rd] degree haemorrhoids. Forty-eight patients [45.7%] presented with prolapse, 33[31.4%] had both bleeding and prolapse and 23[21.9%] had bleeding only. At 3 months of follow up rubber band ligation cured 76[72.4%] patients, improved 13[12.4%] and failed in 7[6.7%] patients. At one year follow up, recurrence of bleeding and prolapse occurred in 16[15.2%] patients having 3rd degree haemorrhoids. Overall success was achieved in 89[84.8%] cases. Complications were seen in 20[19.1%] patients which were of mild to moderate nature and no serious/ life threatening complications were noted. Rubber band ligation is a rapid and safe non operative procedure for treating 1[st], 2[nd] and early 3[rd] degree haemorrhoids on out patient basis