A retrospective analysis of short and long term efficacy of RBL for hemorrhoids.

AIMS: Rubber band ligation is an effective treatment for hemorrhoids. A retrospective analysis was performed to evaluate its short and long-term efficacy.

PATIENTS AND METHODS: From 2000 to 2008, 254 outpatients with II- degree and 114 with III-degree hemorrhoids underwent rubber band ligation. Two or three hemorrhoids were ligated per session. Each haemorrhoid was ligated with two rubber bands through a ligator. All patients were visited after two months and followed up through a telephone after two and eleven years.

RESULTS: Twenty-four or forty-eight hours post treatment, 41% of patients had mild-moderate pain. Four patients showed severe pain and required for haemorrhoidectomy within a few days. Only 2% of patients experienced self-limiting rectal bleeding after one week and 6% of patients had an additional ligation within two months. Two months later, 92% of II-degree patients and 76% of III-degree patients showed no residual symptoms. After two and eleven years, the history of 314 patients (85%) were obtained, of them, 70% was asymptomatic, 27% had some residual symptoms of occasional bleeding and prolapse, and 3% needed further surgery.

CONCLUSIONS: Rubber band ligation is an efficient, cost-effective and simple outpatient procedure for the second and third degree hemorrhoids with minimal complications.