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ORIGINAL ARTICLE
Year : 2018  |  Volume : 31  |  Issue : 1  |  Page : 108-113

Rubber band ligation for bleeding hemorrhoids in hepatic patients


Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Mohamed M. A. Shabana
12/1 Anas Ebn Malek St., New Damietta, Damietta
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.234236

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Objectives The aim of this study was to assess the efficiency of rubber band ligation (RBL) in the treatment of symptomatic hemorrhoids in hepatic patients, versus surgical hemorrhoidectomy. Operative (time and blood loss) and postoperative (pain, bleeding, analgesic requirement, urinary retention, discharge, stenosis, fecal incontinence, wound healing and patient satisfaction) outcomes were evaluated. Background The aim of this study was to compare the outcome of hemorrhoidectomy performed using RBL with surgical hemorrhoidectomy. Patients and methods Forty patients with liver disease and diagnosed with grade I, II, or III hemorrhoids were randomized equally to be subjected to either RBL (group A) or surgical conventional hemorrhoidectomy (group B). Operative details were recorded and patients recorded daily pain scores on a linear analog scale. Follow-up was carried out weekly for 2 months and monthly for 6 months to evaluate complications, return to normal activity, ongoing symptoms, and patient satisfaction. Results Intraoperative blood loss was lower in group A, with a mean of 1.2 ± 1.6 ml (range 0–5 ml) versus 22.2 ± 6.58 ml (range 15–35 ml) in group B (P = 0.0001). Operative time was shorter in group A, with a mean of 9.00 ± 2.449 min (range 5–12 min) versus 24.100 ± 3.669 min (range 20–30 min) in group B (P < 0.001). There was significant difference in postoperative pain scores, analgesic requirement, especially during the first week, and wound healing between the two groups, which was remarkable in the RBL group. There was no difference between the two groups with respect to the degree of patient satisfaction or the number of postoperative complications. Conclusion RBL operation is recommended for the treatment of hemorrhoids in hepatic patients especially in the second and third stage, as it results in less blood loss, less postoperative pain, earlier wound healing, and earlier return to work.


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