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ORIGINAL ARTICLE
Year : 2014  |  Volume : 16  |  Issue : 1  |  Page : 23-29

Comparison of infrared coagulation and rubber band ligation, two simple and cost effective office procedures in the treatment of internal haemorrhoids


Professor & Head, Department of Surgery, ESI Post Graduate Institute of Medical Science and Research & Mahatma Gandhi Memorial Hospital, Parel, Mumbai -400012, Maharashtra, India

Correspondence Address:
Surath C Patra
Professor & Head, Department of Surgery, ESI Post Graduate Institute of Medical Science and Research & Mahatma Gandhi Memorial Hospital, Parel, Mumbai -400012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-3605.203334

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Background: Patients with haemorrhoids or piles visit surgical out-patient departments frequently and are offered various methods of treatment including some Day Care Surgery. Infrared coagulation and Rubber band ligation are considered as two common office procedures for haemorroids. Patients in general are concerned about the effectiveness, post procedure pain and the possibility of future recurrence of a particular procedure and insist on a non-ambiguous reply from the treating surgeon. The surgeon has the moral responsibility to explain to the patient regarding the comfort and efficacy of a particular procedure. In the present study, a comparison has been made between infrared coagulation and rubber band ligation giving greater emphasis on post procedure discomfort and effectiveness. Materials & Methods: One hundredfive patients with second degree bleeding haemorrhoids were treated either by infrared coagulation (N = 51) or rubber band ligation (N = 54). Post procedure, parameters like pain, discomfort, reliefin incidence ofbleeding, time to return to work and recurrence rate were studied and compared following each procedure. Result: The mean duration of disease was 16.5 months (range 12 to 32 months). There were 68 males and 37 females. The mean age was 42.71 years (range 20–71 years). Post procedure pain in first week was more in Rubber Band Ligation group (2-5 vs 0-3 on a visual analogue scale). In Band ligation group post-defecation pain and rectal tenesmus was more intense (P = 0.0059). Patients in Infrared coagulation group had a higher recurrence rate (P = 0.03) but resumed their duties earlier (2 vs 4 days, P = 0.03). Postprocedure, Rubber Band Ligation group had more pain and discomfort but the procedure was more effective in controlling symptoms and obliterating hemorrhoids. Conclusion: Rubber Band Ligation was more effective but more painful, while Infrared coagulation was less painful but their efficacy was also lower. Therefore, It is concluded that Infrared coagulation could be considered a suitable alternative office procedure for early stage haemorrhoids as this office procedure can be conveniently repeated in case of recurrence.


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