A Comparative Study of Open Haemorrhoidectomy versus Rubber Band Ligation in Second Degree Haemorrhoids

Abstract

Bharathi Potluri1 , Venkata Prakash Gandikota2 , Srikanth Reddy Challapalli3 , Keerthinmayee Karimaddela4 , Archana Chilakala5 , Gaddam Yaswanth Kumar6

BACKGROUND Haemorrhoids are one of the most common anorectal disorders. There are various approaches to treat haemorrhoids, but they are associated with greater incidence of pain, hospital stay and higher cost. There is a constant search for a procedure, which is effective as well as economical with less morbidity. The present study aims to compare the effectiveness of rubber band ligation and open haemorrhoidectomy in second degree haemorrhoids. METHODS A prospective study was done among 60 patients admitted in Sri Venkateswara Medical College, Tirupati, between September 2018 and September 2019. Patients with second degree haemorrhoids were divided into two groups namely rubber band ligation group and open haemorrhoidectomy group. Simple random sampling of the study population was done by ascertaining alternate patients to the two study groups. The duration of hospital stay, post-operative clinical course such as pain, bleeding, urinary retention were compared in both the groups. RESULTS The condition is very common in the fourth and sixth decades of life. The mean age group of the study population was 48.6 ± 11.7. Out of 60 patients, 45 patients were male and 15 were female. Males are 3 times more affected than females (M : F = 3 : 1). In open haemorrhoidectomy group, 13 (43.33 %)] patients had a hospital stay of less than two days, whereas 17 (56.67 %) patients had a stay of more than two days. In rubber band ligation group, all 30 patients had a hospital stay of less than two days. There is a highly significant difference between the open haemorrhoidectomy and rubber band ligation groups with regard to the duration of hospital stay (p - value < 0.0001). In open haemorrhoidectomy group, 4 (13.3 %) patients, and rubber band ligation group, only 1 (3.3 %) patient had bleeding. In open haemorrhoidectomy group, 3 (10.0 %) patients and in the rubber band ligation, only 1 (3.3 %) patient had urinary retention. CONCLUSIONS Rubber band ligation is a better procedure for second degree haemorrhoids compared to open haemorrhoidectomy because of shorter hospital stay and less incidence of post-operative complications such as bleeding, postoperative pain, and urinary retention. Rubber band ligation can be done as an outpatient procedure without any requirement of anaesthesia and early return to work.

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