Volume 2, Issue 2 (Spring 2021)                   J Vessel Circ 2021, 2(2): 93-98 | Back to browse issues page


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Dehghan M, Teimouri A. Rubber Band Ligation Versus Medical Therapy For Treatment of Grade II-III Hemorrhoids. J Vessel Circ 2021; 2 (2) :93-98
URL: http://jvessels.muq.ac.ir/article-1-153-en.html
1- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Hezar Jerib St., Isfahan University of Medical Sciences, School of Medicine
2- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Hezar Jerib St., Isfahan University of Medical Sciences, School of Medicine
Abstract:   (1113 Views)
Background and Aim: The most prevalent clinical proctological disorder is internal hemorrhoids. Surgical treatment is a common treatment strategy for this disease. However, due to its significant complications, non-invasive methods are usually more on the agenda. This study aimed to evaluate the treatment results of patients with internal hemorrhoids with rubber band ligation and medication treatment and their one-year follow-up.
Materials and Methods: The current randomized clinical trial was performed on 57 patients with rectal bleeding caused by grade II and III internal hemorrhoids. The patients were randomly divided into two groups of medication treatment and rubber band ligation. The medication treatment with anti-hemorrhoid cream was performed three times a day until complete management of bleeding. The rubber band ligation was performed for another group of patients, and the patients’ need for re-ligation was assessed by monthly examination. Treatment outcomes, recurrence, and complications were compared between the two groups in a 12-month follow-up.
Results: In the medication treatment group, the Mean±SD duration of using anti-hemorrhoid cream for bleeding management was 5.05±2.17 days. In 83.2% of patients, bleeding was controlled well within 6-8 days. The Mean±SD recurrence rate of bleeding was reported 53.3±1.94 times in one year. There was an inverse relationship between patients’ age and recurrence of bleeding (r= -0.78, P<0.001). In the other group treated with rubber band ligation, 25%, 29.6%, and 44.4% of patients required rubber band ligation once, twice, and three times, respectively. Three patients (11.11%) in the rubber band ligation group suffered from complications, including pain (two patients: 7.40%) and minor bleeding (1 patient: 3.70%).
Conclusion: Regarding the minor complications and the remarkable success of rubber band ligation in the eradication of grade II and III hemorrhoids, this method can be recommended as a selective approach of low to moderate hemorrhoids’ treatment, especially treatment-resistant types.
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Type of Study: Research | Subject: vascular hepato-gastroenterology
Received: 2021/09/26 | Accepted: 2021/10/13 | Published: 2021/12/1

References
1. Georges M, Ben Achour H, Adly SA, Trouiller R, Shrivastava R. Clinical efficacy of a new generation of multi-target, anti-edematous, anti-inflammatory, tissue repairing topical polymeric liquid bandage for the treatment of internal hemorrhoids. J Clin Exp Dermatol Res. 2017; 8(4):1000403.[DOI:10.4172/2155-9554.1000403] [DOI:10.4172/2155-9554.1000403]
2. Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and treatment options. Am Fam Physician. 2018; 97(3):172-9. [PMID]
3. Moult HP, Aubert M, De Parades V. Classical treatment of hemorrhoids. J Visc Surg. 2015; 152(2 Suppl):S3-9. [DOI:10.1016/j.jviscsurg.2014.09.012] [PMID] [DOI:10.1016/j.jviscsurg.2014.09.012]
4. Ratto C, Orefice R, Tiso D, Martinisi GB, Pietroletti R. Management of hemorrhoidal disease: New generation of oral and topical treatments. Eur Rev Med Pharmacol Sci. 2020; 24(18):9645-9. [PMID]
5. Lohsiriwat V. Hemorrhoids: From basic pathophysiology to clinical management. World J Gastroenterol. 2012; 18(17):2009-17. [DOI:10.3748/wjg.v18.i17.2009] [PMID] [PMCID] [DOI:10.3748/wjg.v18.i17.2009]
6. Filingeri V, Angelico R, Bellini MI, Manuelli M, Sforza D. Ambulatory therapy with combined hemorrhoidal radiocoagulation. Eur Rev Med Pharmacol Sci. 2013; 17(1):130-3. [PMID]
7. Lohsiriwat V. Treatment of hemorrhoids: A coloproctologist's view. World J Gastroenterol. 2015; 21(31):9245-52. [DOI:10.3748/wjg.v21.i31.9245] [PMID] [PMCID] [DOI:10.3748/wjg.v21.i31.9245]
8. Brown SR. Haemorrhoids: An update on management. Ther Adv Chronic Dis. 2017; 8(10):141-7. [DOI:10.1177/2040622317713957] [PMID] [PMCID] [DOI:10.1177/2040622317713957]
9. Martellucci J, Rossi G, Corsale I, Carrieri P, D'Elia M, Giani I. Myoxinol ointment for the treatment of acute fissure. Updates Surg. 2017; 69(4):499-503. [DOI:10.1007/s13304-017-0450-z] [PMID] [DOI:10.1007/s13304-017-0450-z]
10. Sanchez C, Chinn BT. Hemorrhoids. Clin Colon Rectal Surg. 2011; 24(1):5-13. [DOI:10.1055/s-0031-1272818] [PMID] [PMCID] [DOI:10.1055/s-0031-1272818]
11. Zagriadskiĭ EA, Bogomazov AM, Golovko EB. Conservative treatment of hemorrhoids: Results of an observational multicenter study. Adv Ther. 2018; 35(11):1979-92. [DOI:10.1007/s12325-018-0794-x] [PMID] [PMCID] [DOI:10.1007/s12325-018-0794-x]
12. Chugh A, Singh R, Agarwal PN. Management of hemorrhoids. Indian J Clinic Pract. 2014; 25(6):577-80. https://www.researchgate.net/profile/Anmol-Chugh/pub.pdf
13. Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010; 90(1):17-32. [DOI:10.1016/j.suc.2009.10.005] [PMID] [DOI:10.1016/j.suc.2009.10.005]
14. Higuero T, Abramowitz L, Castinel A, Fathallah N, Hemery P, Laclotte Duhoux C, et al. Guidelines for the treatment of hemorrhoids (short report). J Visc Surg. 2016; 153(3):213-8. [DOI:10.1016/j.jviscsurg.2016.03.004] [PMID] [DOI:10.1016/j.jviscsurg.2016.03.004]
15. Hollingshead JR, Phillips RK. Haemorrhoids: Modern diagnosis and treatment. Postgrad Med J. 2016; 92(1083):4-8. [DOI:10.1136/postgradmedj-2015-133328] [PMID] [DOI:10.1136/postgradmedj-2015-133328]
16. Ng KS, Holzgang M, Young C. Still a case of "no pain, no gain"? An updated and critical review of the pathogenesis, diagnosis, and management options for hemorrhoids in 2020. Ann Coloproctol. 2020; 36(3):133-47. [DOI:10.3393/ac.2020.05.04] [PMID] [PMCID] [DOI:10.3393/ac.2020.05.04]
17. Komporozos V, Ziozia V, Komporozou A, Stravodimos G, Kolinioti A, Papazoglou A. Rubber band ligation of symptomatic hemorrhoids: An old solution to an everyday problem. Int J Colorectal Dis. 2021; 36(8):1723-9. [DOI:10.1007/s00384-021-03900-2] [PMID] [DOI:10.1007/s00384-021-03900-2]
18. Cocorullo G, Tutino R, Falco N, Licari L, Orlando G, Fontana T, et al. The non-surgical management for hemorrhoidal disease: A systematic review. G Chir. 2017; 38(1):5-14. [DOI:10.11138/gchir/2017.38.1.005] [PMID] [PMCID] [DOI:10.11138/gchir/2017.38.1.005]
19. Aram FO. Rubber band ligation for hemorrhoids: An office experience. Indian J Surg. 2016; 78(4):271-4. [DOI:10.1007/s12262-015-1353-1] [PMID] [PMCID] [DOI:10.1007/s12262-015-1353-1]
20. El Nakeeb AM, Fikry AA, Omar WH, Fouda EM, El Metwally TA, Ghazy HE, et al. Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol. 2008; 14(42):6525-30. [DOI:10.3748/wjg.14.6525] [PMID] [PMCID] [DOI:10.3748/wjg.14.6525]
21. Makanjuola A, Balogun OS, Osinowo AO, Adesanya AA, da Rocha JT. Comparison of rubber band ligation with 3% polidocanol injection sclerotherapy for the treatment of internal haemorrhoids at a Nigerian tertiary hospital. Niger Postgrad Med J. 2020; 27(4):311-6. [DOI:10.4103/npmj.npmj_232_20] [PMID] [DOI:10.4103/npmj.npmj_232_20]
22. Longman RJ, Thomson WH. A prospective study of outcome from rubber band ligation of piles. Colorectal Dis. 2006; 8(2):145-8. [DOI:10.1111/j.1463-1318.2005.00873.x] [PMID] [DOI:10.1111/j.1463-1318.2005.00873.x]
23. Sajid MS, Bhatti MI, Caswell J, Sains P, Baig MK. Local anaesthetic infiltration for the rubber band ligation of early symptomatic haemorrhoids: A systematic review and meta-analysis. Updates Surg. 2015; 67(1):3-9. [DOI:10.1007/s13304-015-0286-3] [PMID] [DOI:10.1007/s13304-015-0286-3]
24. Patel S, Shahzad G, Rizvon K, Subramani K, Viswanathan P, Mustacchia P. Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin. World J Clin Cases. 2014; 2(4):86-9. [DOI:10.12998/wjcc.v2.i4.86] [PMID] [PMCID] [DOI:10.12998/wjcc.v2.i4.86]
25. Duchateau A, Huyghe M. Perirectal sepsis after rubber band ligation of haemorrhoids : A case report. Acta Chir Belg. 2014; 114(5):344-8. [PMID] [DOI:10.1080/00015458.2014.11681039]

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