Comparative study of rubber band ligation versus surgical excision in the treatment of second-degree haemorrhoids

Kishore D, Debarath Das, Lakshmana R, Pravin Dhas, S. N, Malarmannan M
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Abstract

Our study focused on comparing the efficacy of Rubber Band Ligation (banding), a day-care and cost-effective procedure, with conventional haemorrhoidectomy in the treatment of haemorrhoids. The study included 120 patients diagnosed through proctoscopic examination, with 60 assigned to each group. Patients were randomly selected through simple alternation for banding or haemorrhoidectomy after receiving procedural explanations and providing consent. Banding, utilizing Barron's band applicator and Hemoband suction device under local anaesthesia, demonstrated notable advantages. Comparison parameters included bleeding, pain, prolapse, and overall relief during follow-ups. Banding showed significantly lower bleeding persistence at 4 weeks compared to haemorrhoidectomy (p < 0.001). Prolapse rates were comparable between the two groups (10%). Complete relief was observed in 1.66% of patients in both groups at the first follow-up (p = 0.929). Banding resulted in moderate pain levels compared to haemorrhoidectomy. Hospital stay duration favoured banding, with 71.66% discharged in 1-3 days, while haemorrhoidectomy had longer stays (3-6 days: 26.66%, >6 days: 1.66%). In conclusion, Rubber Band Ligation emerged as a more effective and preferable method for second-degree haemorrhoids, providing better outcomes, reduced bleeding, and shorter hospital stays compared to conventional haemorrhoidectomy.
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橡皮筋结扎与手术切除治疗二度痔疮的比较研究
我们的研究重点是比较橡胶带结扎术(一种日间护理且经济有效的手术)与传统痔疮切除术在治疗痔疮方面的疗效。该研究包括 120 名通过直肠镜检查确诊的患者,每组 60 人。患者在接受程序说明并同意后,通过简单交替的方式被随机选中,接受绷带术或痔切除术。在局部麻醉的情况下,利用巴伦痔疮带套扎器和痔疮带抽吸器进行痔疮带套扎,显示出显著的优势。比较参数包括出血、疼痛、脱垂和随访期间的总体缓解情况。与痔切除术相比,痔环扎术在 4 周后的出血持续率明显较低(P < 0.001)。两组的脱垂率相当(10%)。首次随访时,两组中均有 1.66% 的患者症状完全缓解(p = 0.929)。与痔切除术相比,绑扎术的疼痛程度适中。住院时间方面,71.66%的患者在1-3天内出院,而痔切除术的住院时间较长(3-6天:26.66%,6天以上:1.66%)。总之,与传统的痔疮切除术相比,橡皮筋结扎术是治疗二度痔疮更有效、更可取的方法,能提供更好的疗效、减少出血并缩短住院时间。
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