Comparison of Infrared Coagulation, Rubber Band Ligation, Injection Sclerotherapy and Hemorrhoidectomy

Hemorrhoidectomy vs. Rubber band ligation
Rubber band ligation vs. Infrared photocoagulation
Rubber band litigation vs. Injection sclerotherapy
Hemorrhoidectomy vs. Fixative procedures

Hemorrhoidectomy vs. Rubber band ligation.

Efficacy: Surgical removal of hemorrhoids (hemorrhoidectomy) may provide better long-term results than rubber band ligation [1]. Rubber band ligation has a 30–50% recurrence rate within 5-10 years of the procedure [4] whereas surgical resection of hemorrhoids has only a 5% recurrence rate.
Risks and complications: Hemorrhoidectomy requires longer recovery times, has a greater risk of complications [1]. Surgery complications may include anal stenosis, fistula formation, bleeding, infection, and urinary retention. Rubber band ligation is associated with least complications. Patients undergoing RBL spent significantly fewer days away from work than patients subject to hemorrhoidectomy. The advantages of the rubber band ligation are indisputable: it offers the possibility of a definitive, ambulatorial with least risk solution to without necessity of hospitalisation and anesthesia, repeatable in the time and with an overall percentage of complications inferior to that of the surgical hemorrhoidectomy [3].
Costs: Surgery is more expensive.

Rubber band ligation vs. Infrared photocoagulation

Efficacy: Rubber band ligation provides longer-lasting relief than infrared photocoagulation therapy. Significantly fewer people undergoing rubber band ligation required additional treatment for symptom recurrence [2]. The better long-term efficacy in people treated with rubber band ligation may be related to the depth of tissue destruction. The rubber band, typically placed at the upper end of the hemorrhoid, leads to necrosis of the hemorrhoidal tissue. Sloughing occurs after 7-10 days, causing moderate tissue destruction with scarring and subsequent fixation of the submucosa. In contrast, infrared photocoagulation creates a small burn, resulting in minimal tissue injury. The decreased depth of injury associated with IRC presumably results in less scarring and tissue fixation, which may explain why more people treated with IRC required additional therapy.
Risks and complications: Infrared photocoagulation is better tolerated than the band ligation.
- Posttreatment pain: Rubber band ligation is associated with a significantly higher incidence of posttreatment pain than Infrared photocoagulation [2]. The difference in posttreatment pain between IRC and rubber band ligation may be the result of differences in depth of tissue injury. Greater tissue depth may result in increased posttreatment pain.
- Life-threatening complications: The results of meta-analysis demonstrated, that although the number of cases has been relatively small, rubber band ligation has been associated with potentially life-threatening complications, such as tetanus, pelvic cellulitis or liver abscess. No such life-threatening complications have been reported with the use of IRC. IRC is easily performed without the need for antibiotics or sterile techniques.

Rubber band litigation vs. Injection sclerotherapy

Efficacy: Rubber band ligation is significantly more effective than injection sclerotherapy and provides longer-lasting relief [5]. Significantly more people treated with sclerotherapy required additional therapy due to the symptomatic recurrence. Rubber band ligation is more effective and less likely to require further therapy than injection. This is shown for first and second-degree haemorrhoids as well as third. RBL was also found to be more cost effective as compared to injection sclerotherapy.
Risks and complications: Complications of sclerotherapy are rare, but usually result from an injection placed too deeply, especially anteriorly in the male. Rubber band ligation causes more pain than sclerotherapy.

Hemorrhoidectomy vs. fixative procedures

Efficacy: Hemorrhoid surgery may give better long-term results than fixative procedures.
Risks and complications: Fixative procedures are less risky and less painful than surgery and require less time off from work and other activities. Surgery is more likely than fixative procedures to cause side effects. These may include: pain, which may last for weeks; bleeding, which may last for a few days; inability to urinate or pass stools; infection.
Cost: Compared with fixative procedures, surgery costs more.

More information about Hemorrhoids:

References:

1. Shanmugam V, Thaha MA, Rabindranath KS, Campbell KL, Steele RJ, Loudon MA. Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy. Br J Surg. 2005 Dec;92(12):1481-7. PubMed
2. Gupta PJ. Infrared coagulation versus rubber band ligation in early stage hemorrhoids. Braz J Med Biol Res. 2003 Oct;36(10):1433-9. Epub 2003 Sep 16. PubMed
3. Pezzullo A, Palladino E. Rubber band ligation of hemorrhoids. 5-year follow-up. G Chir. 2000 May;21(5):253-6. PubMed
4. Savioz D, Roche B, Glauser T, Dobrinov A, Ludwig C, Marti MC. Rubber band ligation of hemorrhoids: relapse as a function of time. Int J Colorectal Dis. 1998;13(4):154-6. PubMed
5. MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum. 1995 Jul;38(7):687-94. PubMed

Neo Healar
Herbal Hemorrhoids Treatment