scholarly journals Belgian consensus guideline on the management of hemorrhoidal disease

2021 ◽  
Vol 84 (1) ◽  
pp. 101-120
Author(s):  
H De Schepper ◽  
G Coremans ◽  
M.A. Denis ◽  
P Dewint ◽  
M Duinslaeger ◽  
...  
Keyword(s):  
Anal Canal ◽  
Treatment Options ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Low Grade ◽  
Delphi Consensus ◽  
Invasive Treatment ◽  
Patient Profile ◽  
Prolapsing Hemorrhoids

Introduction : Hemorrhoidal disease is a common problem that arises when hemorrhoidal structures become engorged and/or prolapse through the anal canal. Both conservative and invasive treatment options are diverse and guidance to their implementation is lacking. Methods : A Delphi consensus process was used to review current literature and draft relevant statements. These were reconciliated until sufficient agreement was reached. The grade of evidence was determined. These guidelines were based on the published literature up to June 2020. Results : Hemorrhoids are normal structures within the anorectal region. When they become engorged or slide down the anal canal, symptoms can arise. Every treatment for symptomatic hemorrhoids should be tailored to patient profile and expectations. For low-grade hemorrhoids, conservative treatment should consist of fiber supplements and can include a short course of venotropics. Instrumental treatment can be added case by case : infrared coagulation or rubber band ligation when prolapse is more prominent. For prolapsing hemorrhoids, surgery can be indicated for refractory cases. Conventional hemorrhoidectomy is the most efficacious intervention for all grades of hemorrhoids and is the only choice for non-reducible prolapsing hemorrhoids. Conclusions : The current guidelines for the management of hemorrhoidal disease include recommendations for the clinical evaluation of hemorrhoidal disorders, and their conservative, instrumental and surgical management.

scholarly journals Non-excisional laser therapies for hemorrhoidal disease: a systematic review of the literature

2020 ◽  
Author(s):  
Gregoire Longchamp ◽  
Emilie Liot ◽  
Jeremy Meyer ◽  
Christian Toso ◽  
Nicolas C. Buchs ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Web Of Science ◽  
Controlled Trial ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Intraoperative Complication ◽  
Band Ligation ◽  
Randomized Controlled ◽  
Database Implementation

Abstract Non-excisional laser therapies are emerging treatment for grades II and III hemorrhoidal disease (HD). However, so far, their efficiency is based on low-level evidence. Therefore, we aimed to systematically review the efficiency of non-excisional laser therapies for HD. MEDLINE/Pubmed, Web of science, Embase, and Cochrane were searched from database implementation until the April 17th, 2020. We included studies reporting at least one of surgical indicators of postoperative outcomes of laser therapies, encompassing laser hemorrhoidoplasty (LH) and hemorrhoidal laser procedure (HeLP). Fourteen studies describing LH and HeLP were included, representing 1570 patients. The main intraoperative complication was bleeding (0–1.9% of pooled patients for LH, 5.5–16.7% of pooled patients for HeLP). Postoperative complications occurred in up to 64% of patients after LH and 23.3% after HeLP. Resolution of symptoms ranged between 70 and 100% after LH and between 83.6 and 90% after HeLP. Moreover, four randomized controlled trials included in our review reported similar resolution after LH compared with hemorrhoidectomy or mucopexy and after HeLP compared with rubber band ligation. Recurrence rate was reported to range between 0 and 11.3% after LH and between 5 and 9.4% after HeLP. When compared with hemorrhoidectomy, LH showed conflicting results with one randomized controlled trial reporting similar recurrence rate, but another reporting decreased recurrences associated with hemorrhoidectomy. Laser therapies showed lower postoperative pain than hemorrhoidectomy or rubber band ligation. LH and HeLP are safe and effective techniques for the treatment of grades II and III HD.

scholarly journals RUBBER BAND LIGATION FOR HEMORRHOIDS (review)

2019 ◽  
Vol 18 (4) ◽  
pp. 151-160
Author(s):  
V. N. Ektov ◽  
К. A. Somov ◽  
A. V. Kurkin ◽  
V. A. Muzalkov
Keyword(s):  
Internal Hemorrhoid ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Band Ligation ◽  
Advantages And Disadvantages ◽  
Multi Stage ◽  
Outpatient Practice ◽  
Methods Of Treatment ◽  
Minimally Invasive Methods

Rubber band ligation is one of the most common and effective minimally invasive methods of treatment of chronic hemorrhoids. An analysis of the experience gained in the use of latex ligation makes it possible to evaluate the advantages and disadvantages of this technique and suggest new options for its implementation. One of the main advantages of rubber band ligation is the radicality of the procedure, which provides the closed removal of internal hemorrhoid piles, which makes it possible to standardize the widespread use of this technique in outpatient practice. When performing the procedure, tool kits of various designs are used, methods of one-stage and multi-stage ligation are used, various technical options are available for applying latex ligatures that affect the pathogenetic factors of hemorrhoidal disease. Optimization of options for the use of rubber band ligation allows to expand the range of use of this technique and provides a rational choice of individual approach.

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 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.

scholarly journals Application of rubber band ligation as a treatment of internal hemorrhoids

2021 ◽  
Vol 9 (8) ◽  
pp. 2235
Author(s):  
Sevil Ozer Sari ◽  
Coşkun Yıldız
Keyword(s):  
Minimally Invasive ◽  
Low Cost ◽  
Laboratory Data ◽  
Rubber Band Ligation ◽  
Treatment Method ◽  
Rubber Band ◽  
Invasive Treatment ◽  
Band Ligation ◽  
Internal Hemorrhoids ◽  
Procedural Success

Background: Aim was to more than three-quarters of the whole population will experience complaints of hemorrhoids at some point in their lifetime. The treatment of internal hemorrhoids includes medical, minimally invasive and surgical treatments. The aim of the study was to evaluate the data of patients who were applied with rubber band ligation (RBL) as a minimally invasive treatment method of internal hemorrhoids.Method: The study conducted in the gastroenterology department of Izmir Tepecik training and research hospital between December 2015 and December 2019. Demographic and laboratory data of the patients, the success and the complications rates of the procedure were evaluated retrospectively .Results: Evaluation was carried out  in 45 consecutive patients, comprising 23 (51.1%) females and 22 (48.9%) males with a mean age of 54.62±7.82 years (range, 40-82 years). Procedural success rate was 91.1% and failure of treatment was seen in 8.9% of the patient. Recurrence rate of RBL procedure determined with control rectoscopy was found as 5.26% at 1 year follow-up. No major complications developed in any patient. Significant correlation was determined between the development of bleeding and the use of anticoagulants and anti-aggregants (p=0.003). No significant relationship was seen between the number of band ligation procedures and the development of complications (p=0.275).Conclusions: The application of RBL, which is widely used in the treatment of internal hemorrhoids, is a reliable and low-cost method that shortens the length of stay in hospital, which can be preferred in patients with high comorbidity risk for surgery. 

scholarly journals Rubber Band Ligation versus Excisional Haemorrhoidectomy A Search for Better Option

1970 ◽  
Vol 20 (2) ◽  
pp. 107-109
Author(s):  
M Nasiruddin ◽  
Mahbubar Rahman ◽  
Haridas Shaha ◽  
Shamima Sultana
Keyword(s):  
Postoperative Complications ◽  
Treatment Options ◽  
Symptom Control ◽  
Rubber Band Ligation ◽  
Rubber Band ◽  
Anal Stenosis ◽  
Band Ligation ◽  
Postoperative Haemorrhage ◽  
Grade Iii

During The period of March-2003 to January-2006 a total of 100 patients with haemorrhoid admitted in Jhenaidah Sadar Hospital and in different private clinics of Jhenaidah and Faridpur town were taken in the study. This study compares the two most popular treatment options for haemorrhoids namely rubber band ligation (R.B.L) and excisional haemorrhoidectomy (E.H). Complete Remission of haemorrhoidal symptoms was better after haemorrhoidectomy than rubber band ligation. Fewer Patients required retreatment after haemorrhoidectomy but anal stenosis, postoperative haemorrhage and incontinence of flatus were more common with this operation. Haemorrhoidectomy produced better long term symptom control in patients with grade III Haemorrhoid but was associated with more postoperative complications than rubber band ligation. doi: 10.3329/taj.v20i2.3069 TAJ 2007; 20(2): 107-109

scholarly journals LASER SUBMUCOSAL DESTRUCTION OF CHRONIC HEMORRHOIDS STAGE II-III

2019 ◽  
Vol 18 (2) ◽  
pp. 21-26
Author(s):  
S. V. Vasiliev ◽  
A. I. Nedozimovanyi ◽  
D. E. Popov ◽  
R. G. Sorkin ◽  
I. V. Gor
Keyword(s):  
Rubber Band Ligation ◽  
Pain Syndrome ◽  
Good Alternative ◽  
Late Results ◽  
Rubber Band ◽  
Hemorrhoidal Disease ◽  
Stage Ii ◽  
Morbidity Rate ◽  
Visual Analogue Pain

AIM: to evaluate the effecacy of laser submucosal destruction using a radial light guide in patients with chronic hemorrhoids (stages II and III).PATIENTS AND METHODS: the study included 65 patients with chronic hemorrhoids, 20% had stage II and 80% – stage III by Goligher classification. Laser submucosal destruction of hemorrhoidal piles has been performed in all patients. The following criteria of assessment were used: pain intensity by visual analogue pain (VAS) scale, the morbidity rate and the time complete wounds healing. Criteria for late results assessment was the severity of the main symptoms of hemorrhoidal disease like piles prolapse, bleeding, thrombosis and anal itching.RESULTS: in 54 (83.1%) patients the postoperative period was uneventful. Postoperative pain syndrome was 3±2 points on VAS scale. Minor postoperative complications were detected in 11 (16.9%) patients. No recurrent hemorrhoids occurred in follow-up.CONCLUSION: laser submucosal destruction is a good alternative for HAL-RAR and STARR procedure for hemorrhoidal disease, when the rubber band ligation and sclerotherapy were ineffective but the time for classical hemorrhoidectomy has not yet come.

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