HEMORRHOIDAL DISEASE: SHORT AND LONG-TERM RESULTS OF RUBBER BAND LIGATION

Aims Hemorrhoidal disease (HM) is probably the most frequent proctologic disorder. There are several therapeutic approaches: medical treatment, instrumental treatment in particularly band ligation and surgical treatment. Rubber band ligation of hemorrhoids (RBLH) remains the main instrumental treatment in our country. The aim of our study was to evaluate the short and long-term outcome of RBLH.

Methods We performed a descriptive, four-year retrospective study (2014-2018). We included all patients who had been treated with RBLH. Demographic, clinical and therapeutic data relating to patients and their disease were analyzed.

Results Thirty-seven patients were included with a male predominance: sex ratio (M/F) = 7.7. The average age was 46 years. 17% of patients were smokers and 43% consumed alcohol. The average follow-up was of 20.4 months [1-72]. The predominant symptomatology was rectorrhagia followed by proctalgia and constipation in 32, 17 and 12 patients respectively. Proctologic examination was motivated by anemia in 28% of cases requiring transfusion in 3 patients. 70% of the patients had internal hemorrhoids (IH) grade 2 according to the Goligher classification; 30% had IH grade 3. The indication for RBLH was a failure of medical treatment in 70% of cases. The average number of RBLH sessions was 4 sessions [1-12] and the average number of elastics per patient was 4. Band ligation was complicated by minimal bleeding in 5 patients (14%). Eleven patients had pain within 6 hours of ligation, with 5 patients requiring the use of analgesics. Three cases of external hemorrhoidal thrombosis have been described. Good results were noticed in the majority of cases (80%) at 5 years follow-up. Two patients had recourse to surgical treatment.

Conclusions In our study, RBLH was an effective and safe technique. These results were concordant with the literature data which underlines the important place of the band ligation in the management of HD.