Justification of Rubber Band Ligation as a Treatment of Choice for Internal Hemorrhoid Grade II and III: a Retrospective Analysis of 116 Consecutive Cases in Maharat Nakhon Ratchasima Hospital - การรักษาริดสีดวงทวารภายในระยะที่ 2 และ 3 ด้วยวิธี Rubber Band Ligation: การศึกษาย้อนหลัง ผู้ป่วยริดสีดวงทวารชนิดภายใน 116 ราย โรงพยาบาลมหาราชนครราชสีมา

Abstract

Hemorrhoid is a common anorectal disease. One method for treating internal hemorrhoids is rubber band
ligation (RBL). The procedure can be performed on most of grade I, II and some of grade III, IV internal
hemorrhoids with low complication rates. This study aimed to determine the outcomes of RBL in Maharat
Nakhon Ratchasima Hospital. It was conducted as a retrospective study, documenting data from all internal
hemorrhoid patients who received RBL at the Department of Surgery during October 2010 to September
2013. There were altogether 116 cases. The male:female ratio was 2:1, with the age range of 18-85 years
old. Most patients were grade II and III internal hemorrhoids (65.5% and 31.9% respectively). After 1-36
month (median=13 months) follow-up of treatment, symptom severity score was found to be significantly
decreased (p<0.001). The complete cure rate was 95.7%. The cure rate in grade II patients was significantly
higher than that of the grade III patients (98.7% vs. 89.2%) (p=0.03). Thus, the RBL should be a preferred
choice in treating internal hemorrhoid patients. It can be performed safely with low complication rates in outpatient
settings.
Key words: hemorrhoid, rubber band ligation, outcome, recurrent