A comparative study on various treatment procedures in the management of hemorrhoids - banding, sclerotherapy and hemorrhoidectomy

Kalpana, R (2013) A comparative study on various treatment procedures in the management of hemorrhoids - banding, sclerotherapy and hemorrhoidectomy. Masters thesis, Madurai Medical College, Madurai.

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Abstract

The experience in the series of 120 patients with various degrees of haemorrhoids treated at Government Rajaji Hospital, Madurai during the period of October 2010 to October 2012 have been reviewed. By analysis of the data obtained, the results are studied and the following findings are noted. 1. Common age group 30-50 yrs. Mean- 40 yrs. 2. Male preponderance. 3. Common clinical feature being bleeding, constipation & prolapse of pile mass. Results regarding management as follows: Sclerotherapy is the better initial treatment option for first degree haemorrhoids which has good acceptable success rate compared to other more invasive and painful procedures. It has following advantages: 1. OP procedure. 2. Less painful. 3. No anaesthesia required. 4. Less complications. 5. Cheaper & faster. 6. Overall Cure rate - 57%. Disadvantages: 1. Multiple injections may be required to achieve good results. 2. Not suitable for higher degree pile masses. Band ligation is the best initial treatment option for second degree haemorrhoids compared to other methods. It can also be used as the initial treatment for early third degree haemorrhoids with acceptable cure rate. Advantages: 1. Less painful. 2. No bowel preparation required. 3. No anaesthesia. 4. Less complications. 5. Cheaper. 6. Overall Cure rate – 75%. Disadvantages: 1. External pile mass & skin tags cannot be treated. 2. Secondary hemorrhage may occur. Surgery (hemorrhoidectomy) remains the gold standard treatment for third and fourth degree haemorrhoids and the patients for whom other less invasive options failed to cure the disease. Advantages: 1. For III & IV degree & recurrent haemorrhoids. 2. External pile mass & skin tags can be removed. 3. Overall Cure rate – 90%. Disadvantages: 1. Painful procedure. 2. Anaesthesia required. 3. More bleeding. 4. Longer duration of stay. On concluding all these results analysis, non operative techniques like sclerotherapy for first degree haemorrhoids and banding for second degree haemorrhoids gives excellent results. Surgical treatment like open & closed hemorrhoidectomy remains the ideal treatment option for third & fourth degree haemorrhoids and recurrent cases.

Item Type: Thesis (Masters)
Uncontrolled Keywords: hemorrhoids - banding ; sclerotherapy ; hemorrhoidectomy ; treatment procedures ; management ; comparative study.
Subjects: MEDICAL > General Surgery
Depositing User: Devi S
Date Deposited: 05 Jun 2018 01:55
Last Modified: 05 Jun 2018 02:37
URI: http://repository-tnmgrmu.ac.in/id/eprint/8198

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