• Syed Asad Ali
  • Agha Taj Mohammad
  • Mohammad Jarwar
  • Javeria Imran
  • Akmal Jamal Siddique
  • Abdul Ghafoor Dalwani


Background: Haemorrhoids is a common anorectal disease seen in our society. Conservativemanagement is usually adopted for 1st and 2nd degree haemorrhoids. Patients who do not respond toabove management are the candidates for other modalities of treatment which includes sclerotherapy,rubber band ligation, cryosurgery and stapler gun or open haemorrhoidectomy. The purpose of studywas to compare the outcome of the Rubber band ligation with Milligan Morgan haemorrhoidectomy inpatients with 2nd and 3rd degree haemorrhoids. Methods: Hundred diagnosed admitted patients ofuncomplicated 2nd and 3rd degree piles were treated either with rubber band ligation (RBL) or openmethod of Milligan Morgan (OH) for the period from January 2007 to December 2007 were includedin the study. Both procedures were evaluated regarding effectiveness, safety, complications afterprocedures, hospital stay and return to work on a written Performa. Patients with 1st and 4th degreehaemorrhoids, below the age of 12 years, bleeding diathesis, associated local anorectal conditionsrequiring surgery, complicated haemorrhoids, recurrent and secondary haemorrhoids were excludedfrom the study. Follow up of all these patients was done in OPD to assess any complication andrecurrence. Data was analysed through SPSS-16.0. Results: One hundred indoor patients with 2nd and3rd degree haemorrhoids were treated either with rubber band ligation or open technique. Most (>90%)of the patients were males. Majority of the patients were in 30–33 years age group. Fresh bleeding(90%) and constipation (45%) were the commonest symptoms followed by prolapsed, discharge andirritation. Second degree was more common than 3rd degree haemorrhoids. Intensive pain was thecommonest complain after both the procedures, however faecal incontinence was not reported in eithergroup. Hospital stay was longer in open technique (70%) compare to few hours to one day in rubberband ligation group. Return to work was earlier in patients treated with rubber band ligation.Conclusion: Rubber band ligation is safe and effective method compare to open technique in 2nd and3rd degree symptomatic haemorrhoids.Keywords: Haemorrhoids, rubber band ligation, Milligan Morgan Procedure, Outcome


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