Complication of Rubber Band Ligation in Second and Third Degree Haemorrhoids

Introduction: Haemorrhoids or piles are symptomatic anal cushions. They can be classified as 1st degree (only bleed), 2nd degree (prolapse but reduce automatically), 3rd degree (prolapse and requires manual reduction) and 4th degree (permanent prolapsed). Haemorrhoids can be managed either conservatively by regular sitz bath, dietary modifications and medications etc., or by minimal invasive procedures like Rubber Band Ligation (RBL), excising and whitehead haemorrhoidectomy. RBL is the most common non surgical and outpatient modality performed, as it is a safe, effective and easier to execute, it is being advised as an Outpatient Department (OPD) procedure. Aim: To study the complications of RBL in 2nd and 3rd degree haemorrhoids. Materials and Methods: The study was conducted as a prospective interventional study at Department of Surgery. The study population consisted of 50 cases of second and third degree haemorrhoids, who underwent RBL as a outpatient procedure. Post-operative complication were studied. Statistical analysis was done using descriptive and inferential statistics through chi-square test. SPSS software 24.0 version and Graph Pad Prism 7.0 version were used in the analysis. Level of significance was considered as less than 0.05. Results: Total 84% had 2nd degree haemorrhoids and 16% had 3rd degree haemorrhoids. The study showed an overall higher success rate (94%) of RBL procedure for 2nd and 3rd degree haemorrhoids; recurrence rate after RBL was 6% (3 patients), when followed-up for a period of 6 weeks The most common complication was pain (62%) followed by urinary retention (8%). The post RBL pain was significantly higher in the 2nd degree haemorrhoids. Conclusion: RBL is an effective, safe outpatient procedure but the complications are more in 3rd degree when compared to 2nd degree haemorrhoids.