Comparative Analysis of Hemorrhoidectomy and Rubber Band Ligation in Grade II-III Internal Hemorrhoids: A Long-Term Outcome Study

Abstract

Background: Hemorrhoidal disease is a common anorectal disorder, with Grade II-III internal hemorrhoids requiring effective treatment options. Hemorrhoidectomy and rubber band ligation (RBL) are widely used, yet their long-term outcomes remain debated. Objective: This study aims to compare the long-term outcomes of hemorrhoidectomy and rubber band ligation in patients with Grade II-III internal hemorrhoids in terms of recurrence, complications, and quality of life. Methods: A prospective study was conducted at the Department of Surgery, Rajshahi Medical College Hospital, from January 2022 to June 2024. A total of 112 patients with Grade II-III internal hemorrhoids were enrolled. Fifty-six patients underwent hemorrhoidectomy, and fifty-six patients underwent rubber band ligation. Both groups were followed up for 12 months post-procedure. Data were collected on symptom resolution, recurrence, complications, and patient satisfaction. Results: The overall recurrence rate for hemorrhoidectomy was 5.4%, compared to 15.1% for rubber band ligation. The standard deviation (SD) for the recurrence rate in the hemorrhoidectomy group was 0.28, while in the RBL group, it was 0.42. The p-value was 0.001, indicating a statistically significant difference in recurrence rates between the two groups. Postoperative complications were more frequent in the hemorrhoidectomy group (14.3%) compared to 7.1% in the RBL group. Patient satisfaction was higher in the RBL group (89.3%) compared to hemorrhoidectomy (72.5%). Conclusion: Hemorrhoidectomy is more effective in preventing recurrence, but it comes with higher complication rates. Rubber band ligation offers a lower-risk alternative with faster recovery and satisfactory long-term results.