Emergency haemorrhoidectomy compared with incision and banding for the treatment of acute strangulated haemorrhoids. A prospective randomised study

Abstract

Objective: To find out if incision and banding was as effective as emergency haemorrhoidectomy in the treatment of strangulated haemorrhoids.

Design: Prospective randomised study.

Setting: Glostrup Hospital, Copenhagen, Denmark.

Subjects: 30 patients with uncomplicated acute strangulated haemorrhoids.

Interventions: Milligan-Morgan haemorrhoidectomy or incision, evacuation of blood clot, and application of elastic bands.

Main outcome measure: Amount of analgesia required, length of stay in hospital, and incidence of complications.

Results: Patients treated by incision and banding required significantly less opioid analgesia and spent significantly fewer days in hospital than those treated by haemorrhoidectomy, but two of them required emergency haemorrhoidectomy because the bands had slipped.

Conclusions: Incision and banding is a reasonable alternative to emergency haemorrhoidectomy provided that it is done correctly, but long term follow up is needed before a final conclusion can be drawn.