Chew Simon S B, Marshall Lynne, Kalish Larry, Tham Jui, Grieve David A, Douglas Philip R, Newstead Graham L
Colorectal Unit, Department of Surgery, Prince of Wales Hospital, Sydney, Australia.
Dis Colon Rectum. 2003 Sep;46(9):1232-7. doi: 10.1007/s10350-004-6720-0.
Rubber band ligation is a common office procedure for symptomatic hemorrhoids. The aim of the study was to assess our short-term and long-term results of combined sclerotherapy and rubber band ligation in the management of hemorrhoids and incomplete mucosal prolapse.
Data on 6,739 patients who had previous combined sclerotherapy and rubber band ligation by the senior authors (GLN and PRD) were retrieved from the database dating between January 1976 and June 2000. These patients either had hemorrhoids or incomplete mucosal prolapse. Furthermore, questionnaires were sent to a random sample of 2,400 patients. Telephone interviews were performed for 600 of the nonrespondents.
Of 6,739 patients (3,683 males; mean age, 46.7 years) in the database, 4,686 (70 percent) received the procedure once, and 2,053 (30 percent) received the procedure more than once. There were 5,689 patients (84 percent) who had their procedures performed consecutively within a planned period, and only 1,050 patients (16 percent) had repeat procedures after a period of more than 12 months from their last treatments. Thus, the recurrence rate was 16 percent. The overall complication rate was 3.1 percent, with minor bleeding being the major complaint. With regard to the questionnaire, 44 percent responded. The mean follow-up period was 6.5 (range, 1-11) years. There were patients who had residual symptoms of bleeding (19 percent), itch (21 percent), and lump (20 percent). However, 58 percent of patients who replied were asymptomatic. With satisfaction scores ranging from +3 to -3 (+3 indicating complete satisfaction and -3 indicating complete dissatisfaction), 90 percent scored >/=1, 9 percent scored 0 or less, and 1 percent did not specify a score. Hemorrhoidectomy was required in 7.7 percent of the responders. Of 600 phone interviews with the nonrespondents, 152 responded to the questionnaires. Although there was less satisfaction from the phone respondents, which may have accounted for the initial nonresponse, no statistical difference was detected in residual symptoms.
Combined triple sclerotherapy and rubber band ligation is an effective treatment for early hemorrhoids and incomplete mucosal prolapse, with low rates of recurrence, complications, and hemorrhoidectomy, and it can be repeated easily.
橡皮圈套扎术是治疗有症状痔的常见门诊手术。本研究旨在评估硬化疗法联合橡皮圈套扎术治疗痔和不完全黏膜脱垂的短期及长期效果。
从1976年1月至2000年6月的数据库中检索资深作者（GLN和PRD）之前进行硬化疗法联合橡皮圈套扎术的6739例患者的数据。这些患者患有痔或不完全黏膜脱垂。此外，向2400例患者的随机样本发送了问卷。对600例未回复者进行了电话访谈。
数据库中的6739例患者（3683例男性；平均年龄46.7岁），4686例（70%）接受过一次该手术，2053例（30%）接受过不止一次该手术。5689例患者（84%）在计划期间内连续接受手术，只有1050例患者（16%）在最后一次治疗超过12个月后接受了重复手术。因此，复发率为16%。总体并发症发生率为3.1%，主要主诉为轻微出血。关于问卷，44%的患者进行了回复。平均随访期为6.5（范围1 - 11）年。有患者存在残留出血症状（19%）、瘙痒（21%）和肿块（20%）。然而，58%回复的患者无症状。满意度评分范围为 +3至 -3（+3表示完全满意， -3表示完全不满意），90%的患者评分≥1，9%的患者评分≤0，1%的患者未给出评分。7.7%的回复者需要进行痔切除术。在对600例未回复者的电话访谈中，152例回复了问卷。尽管电话受访者的满意度较低，这可能是最初未回复的原因，但在残留症状方面未发现统计学差异。
硬化疗法联合橡皮圈套扎术是治疗早期痔和不完全黏膜脱垂的有效方法，复发率、并发症发生率和痔切除术率低，且可轻松重复进行。
