AIM: To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. METHODS: A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to Septem...AIM: To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. METHODS: A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to September, 2006, data was retrieved from archived fi les. RBL was performed using the Mc Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years). RESULTS: After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years. A total of 52 patients (6.93%) had 77 complications from RBL which required no hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms(4.13%, 4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in mean SF-36 scores over baseline in five items, while after 2 years there were improvement in all items over baseline, but not significant. No significant manometeric changes after band ligation. CONCLUSION: RBL is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an out patient procedure with signifi cant improvement in quality of life. RBL doesn't alter ano-rectal functions.展开更多
AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prola...AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prolapse） of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope （preloaded with 7 bands）. Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS： Forty-one patients were included （median age 52.0, range 27-79 years, 20 men）. Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group （P 〈 0.05）. Pain after ligation tended to be more frequent in patients treated with the flexible endoscope （first treatment： 3 vs 20 patients, P 〈 0.05）. Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION： Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.展开更多
文摘AIM: To study the results for the treatment of symptomatic hemorrhoids using rubber band ligation (RBL) method. METHODS: A retrospective study for 750 patients who came to the colorectal unit from June, 1998 to September, 2006, data was retrieved from archived fi les. RBL was performed using the Mc Gown applicator on an outpatient basis. The patients were asked to return to out-patient clinic for follow up at 2 wk, 1 mo, 6 mo and through telephone call every 6 mo for 2 years). RESULTS: After RBL, 696 patients (92.8%) were cured with no difference in outcome for second or third degree hemorrhoids (P = 0.31). Symptomatic recurrence was detected in 11.04% after 2 years. A total of 52 patients (6.93%) had 77 complications from RBL which required no hospitalization. Complications were pain, rectal bleeding and vaso-vagal symptoms(4.13%, 4.13% and 1.33% of patients, respectively). At 1 mo there were a significant improvement in mean SF-36 scores over baseline in five items, while after 2 years there were improvement in all items over baseline, but not significant. No significant manometeric changes after band ligation. CONCLUSION: RBL is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an out patient procedure with signifi cant improvement in quality of life. RBL doesn't alter ano-rectal functions.
文摘AIM： To compare dgid proctoscope and flexible endoscope for elastic band ligation of internal hemorrhoids. METHODS： Patients between 18 and 80 years old, with chronic complaints （blood loss, pain, itching or prolapse） of internal hemorrhoids of grade 1-91, were randomized to elastic band ligation by rigid proctoscope or flexible endoscope （preloaded with 7 bands）. Patients were retreated every 6 wk until the cessation of complaints. Evaluation by three-dimensional anal endosonography was performed. RESULTS： Forty-one patients were included （median age 52.0, range 27-79 years, 20 men）. Nineteen patients were treated with a rigid proctoscope and twenty two with a flexible endoscope. Twenty-nine patients had grade I hemorrhoids, 9 patients had grade 11 hemorrhoids and 3 patients had grade 91 hemorrhoids. All patients needed a minimum of 1 treatment and a maximum of 3 treatments. A median of 4.0 bands was used in the rigid proctoscope group and a median of 6.0 bands was used in the flexible endoscope group （P 〈 0.05）. Pain after ligation tended to be more frequent in patients treated with the flexible endoscope （first treatment： 3 vs 20 patients, P 〈 0.05）. Three- dimensional endosonography showed no sphincter defects or alterations in submucosal thickness. CONCLUSION： Both techniques are easy to perform, well tolerated and have a good and fast effect. It is easier to perform more ligations with the flexible endoscope. Additional advantages of the flexible scope are the maneuverability and photographic documentation. However, treatment with the flexible endoscope might be more painful and is more expensive.
