Long-term result after rubber band ligation for haemorrhoids

Rubber band ligation (RBL) is a well-known and recognised outpatient procedure utilised for the treatment of symptomatic internal haemorrhoids. This paper describes a retrospective study which analyses the short- and long-term results of a personal series of patients.

A consecutive group of 206 patients with symptomatic internal second- and third-degree haemorrhoids were treated with RBL as outpatients from 1982 to 1989. Two or three piles were legated in a single session. All patients were systematically visited after 1 month and 1 year. Respectively after 10 and 17 years, all the patients were contacted to obtain a telephone follow-up.

The short-term follow-up at 1 month and at 1 year showed that 46% of the patients experienced moderate anal pain for 24 h post procedure. Two patients had severe pain (1%) and were admitted in the hospital to be submitted to an operative haemorrhoidectomy within a few days. Only 2.4% of the patients experienced rectal bleeding after a week, and 20% had a second session of RBL after 1 month. At 1 year follow-up, 90% of the patients with second-degree piles and 75% of patients with third-degree piles reported no residual symptoms. The long-term telephone follow-up at 10 and 17 years collected the history of 138 patients (67%). A group of 69% was asymptomatic, 28% had residual symptoms, and 3% needed further surgery.

RBL is a safe and effective treatment for symptomatic internal haemorrhoids. Our long-term follow-up demonstrated good long-term results for internal second- and third-degree haemorrhoids.