Combined rubber band ligation with 3% polidocanol foam sclerotherapy (sclerobanding) for the treatment of second‐degree haemorrhoidal disease. A video vignette

2021 ◽  
Author(s):  
Salvatore Bracchitta ◽  
Luigi M. Bracchitta ◽  
Francesco Pata
Keyword(s):  
Rubber Band Ligation ◽  
Rubber Band ◽  
Foam Sclerotherapy ◽  
Band Ligation ◽  
Haemorrhoidal Disease ◽  
Video Vignette ◽  
Second Degree

scholarly journals Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinical trial.

BMJ ◽  
1983 ◽  
Vol 286 (6375) ◽  
pp. 1387-1389 ◽  
Author(s):  
J L Templeton ◽  
R A Spence ◽  
T L Kennedy ◽  
T G Parks ◽  
G Mackenzie ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Prospective Clinical Trial ◽  
Band Ligation ◽  
Infrared Coagulation ◽  
Second Degree

scholarly journals Sclerobanding (Combined Rubber Band Ligation with 3% Polidocanol Foam Sclerotherapy) for the Treatment of Second- and Third-Degree Hemorrhoidal Disease: Feasibility and Short-Term Outcomes

2021 ◽  
Vol 11 (1) ◽  
pp. 218
Author(s):  
Francesco Pata ◽  
Luigi Maria Bracchitta ◽  
Giancarlo D’Ambrosio ◽  
Salvatore Bracchitta
Keyword(s):  
Rubber Band Ligation ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Long Term Outcomes ◽  
Short Term ◽  
Foam Sclerotherapy ◽  
Band Ligation ◽  
Safe Technique

Background: Sclerobanding is a novel technique combining rubber band ligation with 3% polidocanol foam sclerotherapy for the treatment of hemorrhoidal disease (HD). The aim of this study is to evaluate the feasibility, safety and short-term outcomes of sclerobanding in the treatment of second- and third-degree HD. Methods: A retrospective analysis of second- and third-degree HD cases from November 2017 to August 2021 was performed. Patients on anticoagulants or with other HD degrees were excluded. Follow-up was conducted at 1 month, 3 months, 6 months, 1 year and then every 12 months. Results: 97 patients with second- (20 pts; 20.6%) and third-degree (77 pts; 79.4%) HD with a mean age of 52 years (20–84; SD ± 15.5) were included. Fifty-six patients were men (57.7%) and forty-one women (42.3%). Median follow-up was 13 months (1–26 months). No intraoperative adverse events or drug-related side effects occurred. Minor complications occurred in four patients (4.1%) in the first 30 postoperative days and all resolved after conservative treatment at the 3-month follow-up visit. No mortality or readmissions were observed. Conclusions: Sclerobanding is a safe technique with a low rate of minor postoperative complications. Further studies on larger samples are necessary to establish the effectiveness and long-term outcomes of the technique.

scholarly journals Atsitiktinės atrankos imčių tyrimas lyginant pirmo ir antro laipsnio hemorojaus gydymą perrišant guminiais žiedais su konservatyviu gydymu

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Tomas Poškus ◽  
Kęstutis Strupas
Keyword(s):  
Conservative Treatment ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
University Hospital ◽  
Long Term Results ◽  
Treatment Methods ◽  
Band Ligation ◽  
Key Words Haemorrhoids ◽  
Vilnius University ◽  
Second Degree

Tomas Poškus1,  Kęstutis Strupas21 Vilniaus universiteto ligoninės Santariškių klinikų Centro filialo 3-iasis pilvo chirurgijos skyrius,Žygimantų g. 3, LT-01102 Vilnius2 Vilniaus universiteto ligoninės Santariškių klinikų Gastroenterologijos,nefrourologijos ir chirurgijos klinika, Santariškių g. 2, LT-08660 VilniusEl paštas: [email protected] Tikslas Palyginti konservatyvaus ir mažai invazinio I–II laipsnio hemorojaus gydymą. Ligoniai ir metodai Nuo 2007 m. sausio 1 d. iki 2007 m. liepos 25 d. buvo gydyta 40 asmenų, sergančių I ir II laipsnio hemorojumi, t. y. tokie, kurių hemorojaus mazgai neiškrinta arba iškrinta tuštinantis ir savaime grįžta. Tiriamajam buvo siūloma dalyvauti tyrime, o jam sutikus išankstinės atsitiktinės atrankos būdu buvo priskirtas perrišimo guminiais žiedais arba konservatyvaus gydymo grupei. Po keturių savaičių nuo paskutinės perrišimo procedūros ligonis buvo apklausiamas ir apžiūrimas. Konservatyvaus gydymo grupės ligoniams buvo skiriamas standartinis konservatyvus gydymas – skaidulų turinti dieta, žvakutės Posterisan Forte, Detralex tabletės. Po keturių savaičių ligoniai atvyko pakartotinei apžiūrai. Po keturių savaičių nuo vaistų vartojimo pabaigos ligonis buvo apklausiamas ir apžiūrimas. Duomenys apdorojami EpiInfo programa (www.cdc.gov/epiinfo). Skirtumas tarp grupių buvo vertinamas kaip statistiškai reikšmingas, kai p vertė buvo mažesnė už 0,05. Rezultatai Tyrime dalyvavo 40 asmenų (23 moterys ir 17 vyrų, vidutinis amžius 45,8 metų (nuo 28 iki 73 m.), sirgusių I laipsnio (n = 13, 32,5%) ir II laipsnio (n = 27, 77,5%) hemorojumi. Demografinių ir ligos simptomų skirtumų tarp gydymo grupių nebuvo. Vertindami gydymo metodų poveikį kraujavimui nustatėme, kad perrišimas guminiais žiedais sėkmingiau panaikino kraujavimo simptomus, taip pat pastebėjome tendenciją, kad efektyviau sumažinamas ar panaikinamas iškritimas (14 ligonių po gydymo guminiais žiedais ir 9 ligoniai po konservatyvaus gydymo, p = 0,1). Mūsų tyrime gydymas guminiais žiedais dažniau sukeldavo nedidelių komplikacijų (p < 0,001) – greitai praeinantį silpnumą, neintensyvų skausmą, trunkantį vidutiniškai 2 dienas (nuo 1 iki 4 dienų). Pasitaikė viena pavojinga komplikacija po gydymo guminiais žiedais – praėjus 8 paroms po procedūros ligonis pradėjo gausiai tuštintis krauju ir krešuliais, išsivystė kolapsas ir ligonį teko operuoti – persiūti kraujuojančią vietą. Abu gydymo metodus ligoniai vertino vienodai ir taip pat vienodai rinktųsi tuos pačius gydymo būdus. Išvada Hemorojaus gydymas perrišant guminiais žiedais yra veiksmingesnis negu konservatyvus gydymas flavonoidais, vietiniais preparatais ir skaidulomis, tačiau sukeliantis daugiau komplikacijų. Būtina tirti vėlesnius šios studijos rezultatus, kad būtų nustatytas ilgalaikis abiejų gydymo metodų, ypač konservatyvaus gydymo, efektyvumas. Pacientus informavus apie nemalonius pojūčius gydant hemorojų guminiais žiedais, pasitenkinimas gydymu yra geras. Pagrindiniai žodžiai: hemorojus Randomized controlled trial of rubber band ligation vs. conservative treatment for first and second degree haemorrhoids Tomas Poškus1,  Kęstutis Strupas21 Vilnius University Hospital "Santariškių Clinics", Central Branch,III Department of Abdominal Surgery, Žygimantų str. 3, LT-01102 Vilnius, Lithuania2 Vilnius University Hospital "Santariškių Clinics", Clinic of Gastroenterology,Nefrourology and Surgery, Santariškių str. 2, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Objective To compare the conservative treatment and invasive treatment in 1st and 2nd degree haemorrhoids. Patients and methods 40 patients with first and second degree haemorrhoids were treated from January 1 to July 25, 2007. They complained of either non-prolapsing or prolapsing and spontaneously reducing haemorrhoids. The patients were offered to participate in the study, and with their approval they were randomized to the rubber band ligation or the conservative treatment groups. Four weeks following the last treatment the patients were investigated. Patients in the conservative treatment group were prescribed a standard conservative treatment: fiber addition with wheat, Posterisan Forte suppositories, and Detralex tablets. Four weeks after the end of treatment the patients were investigated and the last questionnaire was filled in. Statistical analysis was performed using Epi Info software (www.cdc.gov/epiinfo). The differences between the groups were statistically significant when the p value was less than 0.05. Results 40 patients (23 female and 17 male) were included in the study, mean age 45.8 years (28–73) with first degree (n = 13, 32.5%) and second degree (n = 27, 77.5%) haemorrhoids. There were no differences between the groups as regards the demographic and clinical data. Rubber band ligation, in our experience, was more effective than conservative treatment in treating bleeding, and we also noted the tendency to better abolish prolapse (14 patients after rubber band ligation and 9 patients after conservative treatment had the disappearance of prolapse, (p = 0.1). Rubber band ligation gave more minor, self-limiting complications (p < 0,001) – minor pain for on average two (1–4) days, vasovagal effects. We encountered one severe complication: 8 days after rubber band ligation, the patient presented hypotensive with massive rectal bleeding; he was admitted to the hospital and operated on, with oversewing the bleeding site. Both treatment methods were evaluated by the patients equally, and both methods would be repeated by the patients, if necessary. Conclusion Rubber band ligation is more effective than conservative treatment with flavonoids, suppositories and fibre, however, it is associated with more complications. Long-term results of both treatment methods, especially after conservative tratment, should be evaluated. When the patients are informed adequately before the procedure, satisfaction with both methods of treatment is equal. Key words: haemorrhoids

scholarly journals Hemorrhoidectomy versus rubber band ligation in treatment of second and third degree hemorrhoids: a comparative study

2019 ◽  
Vol 7 (6) ◽  
pp. 2394
Author(s):  
Nimesh B. Thakkar
Keyword(s):  
Tertiary Care ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Low Grade ◽  
Care Hospital ◽  
Line Treatment ◽  
First Line ◽  
Band Ligation ◽  
First Line Treatment ◽  
Second Degree

Background: Optimum surgical intervention for low-grade haemorrhoids is unknown. Haemorrhoidal artery ligation (HAL) has been proposed as an efficacious, safe therapy while rubber band ligation (RBL) is a commonly used Out patient treatment.Methods: We compared recurrence after HAL versus RBL in patients with grade II-III haemorrhoids. The diagnosis of hemorrhoids is primarily based on the proctoscopic  examination. The study evaluates comparative results of rubber band ligation (RBL) and hemorrhoidectomy. This study was conducted over a period of 1 year from January 2017 to December 2017. It includes 50 patients having second- or third-degree primary hemorrhoids who attended surgical OPD of Tertiary Care Hospital in Gujarat. These 50 patients were selected randomly and divided into two groups of 25 patients each (hemorrhoidectomy group and RBL group). Patients of fissure, fistulae, and malignancy were excluded. All parameters were recorded and finally analysed.Results: Hemorrhoidectomy and RBL are equally effective especially in second-degree hemorrhoids. However, RBL should be considered the first-line treatment in second-degree hemorrhoids because being an outpatient procedure, it is cost effective for the patients, saves many hospital beds for more sick patients, and takes the pressure off the surgical waiting list. Although RBL is not as effective as hemorrhoidectomy in third-degree hemorrhoid, it does improve bleeding and prolapse and is highly recommended for patients who are unfit for surgery.Conclusions: RBL should be considered as the first-line treatment for second-degree hemorrhoid. However, in the third-degree hemorrhoids, hemorrhoidectomy achieves better results, and RBL is recommend as the first-line treatment for those patients in whom there is contraindication for surgery or anesthesia.

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