Factors affecting the success rate of rubber band ligation in haemorrhoid treatment

INTRODUCTION: The aim of this study was to statistically evaluate the use of rubber band ligation (RBL) for the treatment of haemorrhoids, as well as to determine the factors affecting the success of this treatment and to provide recommendations for the most appropriate treatment methods based on those factors
METHODS: The study included patients who received a follow up after undergoing a band ligation procedure between June 2015 and June 2018 in the hospital’s general surgery clinic. Patient’s sex, age, BMI and satisfaction were assessed, along with duration of symptoms, duration of treatment, haemorrhoid grade, follow up period, rebanding rate, examination findings, complications, and constipation score.
RESULTS: A total of 106 patients, 80 males (75.5%) and 26 females (24.5%), were included in the study. The mean follow up period was 29.9 ± 13.5 months, the mean age of patients was 44.2 ± 12.5 years and the mean BMI was 29.2 ± 4.7. The mean duration of symptoms was 8.9 ± 7.6 years and the mean duration of treatment was 6.5 ± 6.2 months. Forty-nine patients (47.1%) had grade 2 haemorrhoids and 55 patients (52.9%) had grade 3 haemorrhoids. Haemorrhoid grade, constipation score and increase in anal tonus were determined to be factors that significantly affected haemorrhoid relapse. Moreover, patient satisfaction was lower in patients with higher constipation score or increased anal tonus.
DISCUSSION AND CONCLUSION: Band ligation is a safe, effective treatment for haemorrhoids that can be applied easily to most patients, however, it may not be the first choice for all patients. Alternative procedures may be recommended for patients with higher constipation scores or increased anal tonus, as these factors may affect success for those patient groups.

Hemoroidde lastik band ligasyonu sonuçlarýný etkileyen faktörler

GÝRÝÞ ve AMAÇ: Lastik band ligasyonu yaptýðýmz hastalarýmýzýn bulgularýný ve sonuçlarýný istatistiki olarak deðerlendirmek, tedavinin sonucunu etkileyen faktörleri belirlemek ve hangi hastalarda bu yöntemin daha uygun olduðu konusunda kanaat oluþturmaktýr.
YÖNTEM ve GEREÇLER: Hastanemiz genel cerrahi kliniðinde haziran 2015 ve haziran 2018 tarihleri arasýnda band ligasyonu yapýlan ve takibebe gelen hastalar dahil edildi. Hasta cinsiyeti, yaþý, BMI, þikayet süresi, tedavi süresi, hemoroidin evresi, iþlem tarihi, takip süresi, tekrar bandlama yapýlmasý, muayane bulgularý, komplikasyonlar, kabýzlýk skoru ve hasta memnuniyeti parametrelerine bakýldý.
BULGULAR: Çalýþmaya 80 erkek (%75,5) ve 26 kadýn (%24,5) olmak üzere toplam 106 hasta alýnmýþtýr. Ortalama takip süresi 29,9±13,5 ay, hastalarýn yaþ ortalamasý 44,2±12,5 ve BMI ortalamasý 29,2±4,7 dir. Ortalama þikâyet süresi 8,9±7,6 yýldýr. Tedavi süresi ortalama 6,5±6,2 aydýr. Hastalardan 49 (%47,1) unda grade 2, 55 (%52,9) inda grade 3 hemoroid tespit edildi.
Nüks olan hastalar incelendiðinde hemoroidin derecesi, kabýzlýk skoru ve anal tonus artýþýnýn nükste anlamlý derecede etkili olduðu bulundu. Ayrýca kabýzlýk skoru yüksek olan veya anal tonusu yüksek olan hastalarda memnuniyet oranlarý anlamlý derecede düþük bulundu.

TARTIÞMA ve SONUÇ: Band ligasyonu kolay uygulanabilir, baþarýlý ve güvenli bir yöntemdir. Ancak bütün hastalar için ilk seçenek olmayabilir. Bazý hasta gruplarýnda baþarýyý etkileyen faktörlerin tespiti durumunda tedavide alternatif ofis prosedürü seçenekleri düþünülebilir.