Sclerotherapy vs Band Ligation: A comparative study of efficacy and compliance in second degree Haemorrhoids
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Abstract
Background: Sclerotherapy and rubber band ligation represent two widely employed minimally invasive procedures for managing grade II haemorrhoids.
Objectives: To compare the postoperative pain in patients undergoing sclerotherapy vs rubber band ligation for grade II haemorrhoids; and to compare the rate of recurrence after three months.
Methods: This was a hospital based, prospective comparative study conducted among patients presenting to the Department of General Surgery, JSS Medical College, Mysuru, Karnataka, India with symptomatic grade II haemorrhoids, between June 2022 to June 2024.
Results: A total of 80 patients were enrolled – 40 in Group A undergoing sclerotherapy, and 40 patients in Group B undergoing rubber band ligation. The baseline characteristics of the study groups namely age (in years), gender, presenting symptoms, mean duration of symptoms, vitals (including pulse rate, systolic and diastolic blood pressure), position of haemorrhoids in per rectal examination, and laboratory investigations did not vary significantly between the study groups (p>0.05). Pain scores, measured using the Visual Analogue Scale, showed no significant difference on Day 1 (mean 8.8), but by Day 3, Group A reported significantly lower pain (mean 7.3) compared to Group B (mean 8.3), a trend that persisted through Week 2 and Month 3. Per rectal bleeding was significantly higher in Group A on Day 1 (55% vs. 30%), but decreased over time, becoming statistically insignificant by Month 3. Recurrence rates were 15% for Group A and 10% for Group B, with no significant difference. Urinary retention occurred in 10% of Group A and 7.5% of Group B, while anal strictures and incontinence were present in a small percentage of both groups, with no significant differences observed for any of these complications.
Conclusion: Sclerotherapy resulted in lower pain scores and rubber band ligation had reduced incidence of early postoperative bleeding compared to sclerotherapy.