Prospective randomised comparison of rubber band ligation (RBL) and combined hemorrhoidal radiocoagulation (CHR)

In this prospective randomized study we compared two groups of patients with grade II hemorrhoids treated with standard Rubber Band Ligation (RBL) and Combined Hemorrhoidal Radiocoagulation (CHR), respectively.

Out of 90 patients initially randomized, a total of 75 patients regularly returned to visit controls at least for 6 months of follow-up. Consequently, two groups of patients were considered: Group A, represented by 36 individuals treated with RBL, and Group B, consisting of 39 patients treated with CHR. In this study primary endpoints were determined as evaluation of the grade of pain felt immediately after the procedure and at the first evacuation (score from 1 to 10), bleeding, patient's satisfaction after 15 days and after 6 months from the treatment (score from 1 to 10), appearance of failures.

Comparing two techniques, the mean pain score reported immediately after the procedure was 2.08 +/- 1.1 for Group A and 2.13 +/- 1.26 or Group B. At the first evacuation, the mean pain score for Group A and for Group B was 2.69 +/- 1.12 vs. 2.38 +/- 1.18, respectively. The satisfaction score during the first 15 days from the procedure was 6.61 +/- 2.35 for patients treated with RBL and 6.72 +/- 2.28 for patients who received CHR, while the mean score on overall satisfaction after 6 months was 7.11 +/- 2.11 (Group A) vs. 7.31 +/- 2.04 (Group B). At 6 months of follow-up, we observed remission of symptoms in 25 patients in Group A (69.4%) and 31 patients in Group B (79.5%).

Satisfactory results were reported in both groups of patients after different treatments, which confirm the validity and efficacy of the two techniques used in this study. At least all patients reported positive results in terms of immediate and long-term comfort after both procedures. CHR showed better results than standard RBL, but further studies are required to evaluate the validity of these methods.