A Comparative Study of Rubber Band Ligation and Sclerotherapy in Patients With Second Degree Haemorrhoids
Year: 2018
Type: article
Abstract: BACKGROUND \nHaemorrhoids are an extremely common surgical condition of anorectal area. With the available non-surgical approaches for \nhaemorrhoids like infrared coagulation, bipolar diathermy, direct current therapy, cryotherapy, etc. the number of \nhaemorrhoidectomies performed has decreased significantly over time.12 Rubber band ligation and injection sclerotherapy have \nbecome the mainstays of outpatient treatment for patients presenting with grade 1 to 2 haemorrhoids. \nMATERIALS AND METHODS \nThe study was carried out between November 2016 and October 2017 over a period of twelve months. A total of 142 patients \nwith second degree haemorrhoids who consented to participate in the study were included. A detailed history was obtained \nwith emphasis on symptoms, occupation and dietary habits. All patients underwent digital rectal examination and proctoscopy. \nIn sclerotherapy group, with the patient in left lateral position, 3 to 5 ml of 5% phenol in groundnut oil was injected into a point \nabove the main mass of haemorrhoid into the sub mucosa, till elevation and pallor of the mucosa was seen. Similarly, in rubber \nband ligation group one rubber band was applied on each haemorrhoidal bundle on rectal mucosa. Patients were followed up \nat intervals of 3 weeks, 6 weeks and 9 weeks. At each followup, symptoms of bleeding, prolapse, discomfort, discharge, pruritus \n/ irritation were assessed. Intraoperative pain during the treatment was assessed on a visual analogue scale (VAS) ranging from \n1 to 10 with 1 indicating no pain and 10 the worst pain. If the patient was still symptomatic, further treatment given up to a \nmaximum of three times. Patients failing to respond after these three visits for treatment were considered as treatment failure \nand surgery advised. \nRESULTS \nIn comparison of rubber band ligation and sclerotherapy, we found out that all the symptoms of haemorrhoids showed \nimprovement over the course of 9 weeks in both treatment groups. Significantly more number of patients in the Rubber band \nligation group had excellent symptomatic relief on patient assessment when compared to sclerotherapy group. Shrinkage of \nhaemorrhoids was also significantly less in sclerotherapy group as compared to rubber band ligation group. \nCONCLUSION \nIt was therefore seen that sclerotherapy is slower to give symptomatic relief of bleeding and prolapse compared to rubber band \nligation.
Authors: Selvaraj V, Uma Balakrishnan
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2804852459