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A prospective study of outcome from rubber band ligation of piles
Author(s) -
Longman R. J.,
Thomson W. H. F.
Publication year - 2006
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2005.00873.x
Subject(s) - medicine , asymptomatic , surgery , complication , prospective cohort study
Objective With the recent introduction of stapled anopexy it is timely to review the benefits of existing treatment options for piles. This study investigates the effectiveness and safety of rubber band ligation (RBL) of piles in the outpatient setting. Patients and methods Two hundred and fifty‐two consecutive patients referred with piles in an 18‐month period were studied prospectively. In those patients deemed suitable for banding of piles, data were collected on symptoms, proctoscopic appearance and degree of piles. Short and long‐term outcome data were recorded for success of treatment and complications. Results Of 203 patients considered suitable and who attended for RBL, 176 kept their follow‐up appointment. One hundred and forty‐eight (84%) had been rendered symptom‐free. A third of patients, however, had proctoscopic evidence of persistent piles, whilst in half of those patients with continuing symptoms the anal cushions appeared normal. Six (3%) patients had suffered a complication. Long‐term follow‐up by questionnaire found that 44% of respondents remained asymptomatic at a median of 46 months from banding. Six (5%) of 117 responders to the questionnaire had, though previously normal, suffered a postbanding impairment of continence. Conclusion Most patients with piles of any degree can be safely managed by rubber band ligation, but return of symptoms in the long term affects more than half of patients treated.