Arshad Zafar.
Rubber band ligation in Hemorrhoids.
J Coll Physicians Surg Pak Jan ;12(1):48-51.

Objective: Hemorrhoids is a very common medical condition. A large number of cases can be managed by non-surgical means. The purpose of this study is to evaluate the therapeutic results of rubber band ligation in hemorrhoidal disease. Design: Prospective case series with a minimum follow up of 1 year. Place and Duration of Study: Surgical clinic over a period of 2 years and 7 months from February 1997 to August 1999. Subjects and Methods: One hundred patients with 1st, 2nd and 3rd degree symptomatic hemorrhoids had rubber band ligation on outdoor basis in one session. They were examined weekly for one month and every two-month for one year. Subjective and objective symptoms (bleeding and prolapse) were noted. Rectal examination and proctoscopy were done. Therapeutic effect was assessed by symptomatic improvement of bleeding and prolapse and any complication on follow-up. Results: Twenty-two patients had 1st degree, 48, 2nd degree and 30 3rd degree hemorrhoids. Twenty-two (22%) patients presented with bleeding, 46(46%) with prolapse while 32(32%) presented with both bleeding and prolapse. Rubber band ligation cured 72 (72 %) patients, improved 10 (10%) and it failed in 8 (8%) patients. After one year follow-up, recurrence of bleeding and prolapse occurred in 10 (10%) patients. Complications were seen in 52 patients, however, no serious and life-threatening complications were seen. Conclusion: Rubber band ligation is a rapid, safe, effective and economical method of treating 1st, 2nd and early 3rd degree hemorrhoids in the outdoors.

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