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

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.