A Prospective Audit of Early Pain and Patient Satisfaction Following Out-Patient Band Ligation of Haemorrhoids

Watson, Nicholas; Liptrott, Sarah Jayne; Maxwell-Armstrong, Charles

doi:10.1308/003588406x98649

Cited by 36 publications

(19 citation statements)

References 5 publications

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“…In a prospective study[ 26 ] specifically evaluating pain and patient satisfaction following RBL of hemorrhoids, pain was the most common symptom occurring in almost 90% of patients, with the pain scores higher 4 h following the procedure. At 1 wk, 75% of patients reported themselves as being pain-free; however, 7% were still experiencing moderate-to-severe pain.…”

Section: Complications Of Rblmentioning

confidence: 99%

Rubber band ligation of hemorrhoids: A guide for complications

Albuquerque

2016

WJGS

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Rubber band ligation is one of the most important, cost-effective and commonly used treatments for internal hemorrhoids. Different technical approaches were developed mainly to improve efficacy and safety. The technique can be employed using an endoscope with forward-view or retroflexion or without an endoscope, using a suction elastic band ligator or a forceps ligator. Single or multiple ligations can be performed in a single session. Local anaesthetic after ligation can also be used to reduce the post-procedure pain. Mild bleeding, pain, vaso-vagal symptoms, slippage of bands, priapism, difficulty in urination, anal fissure, and chronic longitudinal ulcers are normally considered minor complications, more frequently encountered. Massive bleeding, thrombosed hemorrhoids, severe pain, urinary retention needing catheterization, pelvic sepsis and death are uncommon major complications. Mild pain after rubber band ligation is the most common complication with a high frequency in some studies. Secondary bleeding normally occurs 10 to 14 d after banding and patients taking anti-platelet and/or anti-coagulant medication have a higher risk, with some reports of massive life-threatening haemorrhage. Several infectious complications have also been reported including pelvic sepsis, Fournier’s gangrene, liver abscesses, tetanus and bacterial endocarditis. To date, seven deaths due to these infectious complications were described. Early recognition and immediate treatment of complications are fundamental for a favourable prognosis.

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Section: Complications Of Rblmentioning

confidence: 99%

Rubber band ligation of hemorrhoids: A guide for complications

Albuquerque

2016

WJGS

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“…3,4 Historically, the most practiced surgical procedures for hemorrhoids were hemorrhoidectomies according to Milligan Morgan and Fergusson techniques. 5,6 Over the last few years, there has been increasing attention on surgical procedures to treat hemorrhoids. Several comparative studies have been performed to evaluate the procedures already available to treat second, third, and fourth-degree haemorrhoids, and new surgical techniques.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of open and closed hemorrhoidectomy

2018

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Background: Hemorrhoidectomy is the treatment of choice for patients with third-degree or fourth-degree haemorrhoids. This prospective randomized clinical study compared the outcome of surgical haemorrhoidectomy by open and closed techniques in terms of postoperative pain, wound healing, and morbidity.Methods: All consecutive patients with Grade III internal haemorrhoids or Grade IV haemorrhoids were randomly allocated to one of two groups. The entire wound was left open in the open group and completely closed using 2-0 chromic sutures in the closed group. Postoperative pain was assessed by a linear analog scale. Additional consumption of analgesics on the day of surgery and at defecation during the first week was recorded. Patients were followed up 1, 2, and 3 weeks after the procedure.Results: There were 30 patients in each group. No statistically significant differences were found between the two methods regarding complications, pain, or postoperative stay. There were four reoperations for bleeding, all after Milligan-Morgan operations. At follow-up after three weeks 78 percent of the Ferguson patients had completely healed wounds, and none had signs of infection. Of the Milligan-Morgan patients, only 26 percent had completely healed wounds, and symptoms of delayed wound healing were significantly more frequent.Conclusions: Both methods are fairly efficient treatment for third and fourth degree hemorrhoids, without serious drawbacks. The closed method has no advantage in postoperative pain reduction but is more advantageous with respect to faster wound healing.

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“…Historically, the most practiced surgical procedures for hemorrhoids were hemorrhoidectomies according to Milligan Morgan and Fergusson techniques [6,7]. A major innovation has been the introduction of Harmonic Scalpel, monopolar shears (Ethicon Endosurgery, Cincinnati, OH) [8] and Stapled Transanal Rectal Resection (STARR) [9].…”

Section: Introductionmentioning

confidence: 99%

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

Guraya

Khairy²

2013

JCDR

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Objectives: This study was designed to evaluate the effectiveness of stapled hemorrhoidectomy (SH) in terms of cure of the symptoms and post-operative pain control. Material and Methods:In this prospective clinical study, SH (Ethicon Endo-surgery, Cincinnati, OH) was performed for all patients with grade III and grade IV hemorrhoids, presenting to the surgical clinics of Ohud and Meeqat Hospitals Almadinah Almunawwarah Saudi Arabia. The results of SH were evaluated by a questionnaire focusing on the relief of symptoms, severity of post operative pain, and complications of SH.Results: Thirty patients (21 males and 9 females); with a mean age of 39.6 years were recruited in this study. Twenty six (86%) patients had grade III and 4 (14%) presented with grade IV hemorrhoids. Perianal prolapse was the most frequent presentation reported in 23 (76%). Mean operating time was 21.7 minutes (range; 17-36 minutes) whereas mean hospital stay was 1.9 days. Post-operative pain was tolerable (nonpersistent) in 28 (93%) cases whereas 2 (7%) experienced mild pain requiring additional analgesia. Urinary retention was the most common complication found in 5 (16%) patients. All patients were cured of the hemorrhoids Conclusion: SH is a safe, rapid, and convenient surgical remedy for grade III and grade IV hemorrhoids with low rate of complications, minimal postoepative pain, and early discharge from the hospital.

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A Prospective Audit of Early Pain and Patient Satisfaction Following Out-Patient Band Ligation of Haemorrhoids

Cited by 36 publications

References 5 publications

Rubber band ligation of hemorrhoids: A guide for complications

Rubber band ligation of hemorrhoids: A guide for complications

A comparative study of open and closed hemorrhoidectomy

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

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