Pain, Bleeding, and Recurrence Profiles in Hemorrhoidectomy vs. Rubber Band Ligation: A Prospective Randomized Trial

Abstract

Background: Hemorrhoidal disease is a common condition leading to significant morbidity. Treatment options include hemorrhoidectomy and rubber band ligation (RBL), with varying postoperative outcomes. Objective: This study aims to compare the pain, bleeding, and recurrence profiles between hemorrhoidectomy and rubber band ligation in treating hemorrhoidal disease. Methods: A prospective randomized trial was conducted at the Department of Surgery, Rajshahi Medical College Hospital, from June 2022 to December 2023. A total of 122 patients (61 in each group) with grade III or IV hemorrhoids were randomly assigned to undergo either hemorrhoidectomy or RBL. Pain was assessed using the Visual Analog Scale (VAS), bleeding was monitored for postoperative complications, and recurrence was tracked over 6 months. Statistical analysis included mean comparison, standard deviation, and p-value calculation for each parameter. Results: The mean pain score was significantly higher in the hemorrhoidectomy group (mean = 7.5, SD = 1.2) compared to the RBL group (mean = 3.2, SD = 0.9), with a p-value of 0.001, indicating significant difference. Postoperative bleeding was observed in 12% of hemorrhoidectomy cases compared to 4.5% in the RBL group (p = 0.038). Recurrence at 6 months was higher in the RBL group (18%) compared to the hemorrhoidectomy group (8%), with a p-value of 0.04. Conclusion: Hemorrhoidectomy offers better long-term outcomes with lower recurrence rates but is associated with higher pain and bleeding compared to rubber band ligation.