COMPARISON BETWEEN INJECTION SCLEROTHERAPY AND RUBBER BAND LIGATION FOR FIRST AND SECOND DEGREE HAEMORRHOIDS
Background: For first and second degree haemorrhoids, the preferred outpatient treatments are injection sclerotherapy or rubber band ligation of the haemorrhoids. The aims of this study were to compare postoperative pain, postoperative and delayed bleeding after injection sclerotherapy and rubber band ligation of first and second degree haemorrhoids. Methods: From January 2016 to January 2017, 60 patients were alternately allocated to undergo either injection sclerotherapy (group A) or rubber band ligation of the haemorrhoids (group B). Pain sores, and frequency of early and delayed per-rectal bleeding were compared between the two groups. Results: Postoperative pain was present in 9 patients (30%) in sclerotherapy group and 15 patients (50%) in rubber band ligation group. Per-rectal bleeding was more common in rubber band ligation group (56% vs 26%; p=0.018). Delayed bleeding was more common in rubber band ligation group (30% vs. 3%; p=0.0006). Conclusion: Injection sclerotherapy of first and second degree haemorrhoids is associated with fewer complaints of pain and per-rectal bleeding, both early and delayed.
Keywords: Haemorrhoids, sclerotherapy, rubber band ligation, pain, bleeding
Pak J Physiol 2017;13(2):15–8
2. Sardinha TC, Corman ML. Hemorrhoids. Surg Clin North Am 2002;1153–67.
3. Benzoni E, Milan E, Cerato F, Narisetti P, Bresadola V, Terrosu G. Second degree hemorrhoids: Patients satisfaction: Immediate and longer results or rubber band ligation. Minerva Chir 2006;61:119–24.
4. Shanmugum V, Thaha MA, Rabindranath KS, Campbell KL, Steele RJ. Rubber band ligation versus excisional hemorrhoidectomy for hemorrhoids. Cochrane Database Syst Review 2005;CD005034.
5. Takano M, Iwadare J, Ohba H, Takamura H, Masuda Y, Matsuo K, et al. Sclerosing therapy of internal hemorrhoids with a novel sclerosing agent: Comparison with ligation and excision. Int J Colorectal Dis 2006;21:44–51.
6. Khanevich MD, Mirumian RV. Sclerotherapy of hemorrhoids. Vest Khir Im II Grek 2004;163:132–4.
7. Chew SS, Marshall L, Kalish L, Tham J. Grieve DA, Douglas PR, et al. Short-term and long-term results of combined sclerotherapy and rubber band ligation of hemorrhoids and mucosal prolapsed. Dis Colon Rectum 2003;46:1232–7.
8. Kanellos I, Goulimaris I, Christoforidis E, Kelpis T, Betsis D. A comparison of the simultaneous application of sclerotherapy and rubber and ligation, with sclerotherapy and rubber band ligation applied separately, for the treatment of haemorrhoids: a prospective randomized trial. Colorectal Dis 2003;5:133–8.
9. Hardy A, Chan CL, Cohen CR. The surgical management of hemorrhoids: A review. Dig Surg 2005;22:26–33.
10. Pandya JS, Palep JH, Dhadas A, Desai NK. Comparison of rubber band ligation and injection sclerotherapy for first and second degree hemorrhoids: a prospective clinical trial. Bombay Hosp J 2004;46:28–30.
11. Sandhu PS, Singh K. A randomized comparative study of micronized flavinoids and rubber band ligation in the treatment of acute internal hemorrhoids. Indian J Surg 2004;66:281–5.
12. Qureshi S, Aziz T, Afzal A, Maher M. Rubber band ligation of symptomatic internal haemorrhoids; result of 450 cases. J Surg Pak 2009;14(1):19–22.
13. Mahmood S, Malik AU, Qureshi S, Khan IA. Rubber band ligation vs injection sclerotherapy in early hemorrhoids. Ann King Edward Med Uni 2001;7(3):219–23.
14. Jehan S, Ateeq M, Ali M, Bhopal FG. Sclerotherapy versus rubber band ligation; comparative study of efficacy and compliance in the treatment of uncomplicated second degree haemorrhoids. Professional Med J 2012;19(2):222–7.
15. Giamundo P, Salfi R, Geraci M, Tibaldi L, Murru L, Valente M. The hemorrhoid laser procedure technique vs rubber band ligation: a randomized trial comparing 2 mini-invasive treatments for second- and third-degree hemorrhoids. Dis Colon Rectum 2011;54(6):693–8.
16. Cazemier M, Felt-Bersma RJ, Cuesta MA, Mulder CJ. Elastic band ligation of hemorrhoids: Flexible gastroscope or rigid proctoscope? World J Gastroenterol 2007;13(4):585–7.
17. Bernal JC, Enguix M, Lopez Garcia J, Garcia Romero J, Trullenque Peris R. Rubber-band ligation for hemorrhoids in a colorectal unit. A prospective study. Rev Esp Enferm Dig 2005;97(1):38–45.
18. Nisar PJ, Scholefield JH. Managing hemorrhoids. BMJ 2003;327:847–51.
19. Watson NFS, Liptrott S, Maxwell-Armstrong CA. A prospective audit of early pain and patient satisfaction following out-patient band ligation of haemorrhoids. Ann R Coll Surg Engl 2006;88:275–9.
20. Bhutta AR, Shaukat A, Farooqi F. Rubber band ligation of second degree hemorrhoids (our experience). Pak J Med Health Sci 2007; 1: 96–8.
21. Dilawaiz, Murtaza G, Rasheed A, Rehman Q, Hussain R. Rubber band ligation; postoperative complications after treatment of internal hemorrhoids. Professional Med J 2007;14(1);104–10.
22. Mann CV. Injection of hemorrhoids. In: Dudley H, Pories WJ, Carter DC, (Eds). Rob and Smith’s Operative Surgery. 4th ed. London: Butterworths; 1983. pp. 467–9.
23. Chaleoykitti B. Comparative study between multiple and single rubber band ligation in one session for bleeding internal hemorrhoids: a prospective study. J Med Assoc Thai 2002;85:345–50.
24. Dilawaiz M, Bashir MA, Rashid A. Hemorrhoidectomy vs rubber band; comparison of post operative complications. Professional Med J 2011;18(4):571–4.
25. MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 1995;38:687–94.
26. MacRae HM, McLeod RS. Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg 1997; 40: 14–7.
27. Greca F, Hares MM, Nevah E, Alexander-Williams J, Keighley MR. A randomized trial to compare rubber band ligation with phenol injection for treatment of haemorrhoids. Br J Surg 1981;68:250–2.
28. Gartell PC, Sheridan RJ, McGinn FP. Out-patient treatment of haemorrhoids: a randomized clinical trial to compare rubber band ligation with phenol injection. Br J Surg 1985;72:478–9.
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