Study 1
Doctors Who Conducted Study: Lee HH, Spencer RJ, Beart RW Jr.
Title: Multiple hemorrhoidal bandings in a single session
Purpose of Study: To assess the risks of multiple banding in one session
Study Dates: Retrospective examination of patients who had bandings performed between July 1989 and August 1992.
Findings: Patients who underwent multiple bandings in a single session experienced more pain and discomfort than patients who only had one banding (29% vs. 4.5%), but although there was more pain, most patients were able to control the pain with pain relievers. The multiple banding patients also experienced more vasovagal symptoms (these are symptoms related to the vagus nerve which may lead to fainting) (5.2% vs. 0%). Multiple banding patients also had more swelling (2.6% vs. 0%), more urinary hesitancy and frequency (12.3 vs. 0%). However, no multiple banding patients experienced major complications such as massive delayed bleeding or sepsis.
Conclusion: Although multiple bandings in a single session did result in additional risk factors, the risks were found to be "acceptably low" and a "safe and cost-effective alternative".
Study 2
Doctors Who Conducted Study: Di Giorgio A, Arnone P, Canavese A, al Mansour M, Campagna SA, Pallotti M.
Title: Ambulatory treatment of hemorrhoidal pathology with elastic bands according to a modified Barron technique
Purpose of Study: To study the effectiveness of rubber band ligation using a modified Barron method
Study Dates: Results published in 1997
Findings: This study involved the use of a ligator with suction which is a modification of the Barron ligator.
The study involved 84 patients who had multiple treatments over 18 months with follow-up of 6 months, 40 patients were male and 44 were female. On average, the male patients had experienced symptoms of 9 years, while the female patients had experienced the symptoms for 8.9 years. On average, treatments consisted of 3.4 session and 3.6 rubber band ligations.
9 patients had previous received other treatments including: rubber band ligation (3 patients), hemorrhoidectomy (4 patients), sclerotherapy (1 patient) and rubber band ligation and sclerotherapy (1 patient). 10.7 % of patients had Grade I hemorrhoids, 19% Grade II hemorrhoids and 70.2% of patients had Grade III hemorrhoids. A lot of the patients involved in this study had the following pre-existing symptoms: 34 had anal pain, 49 had bleeding, 5 experienced anemia, 21 had thrombosis of the hemorrhoidal plexus, 54 had prolapse, most patients had multiple symptoms.
During the study 285 sessions were performed and 304 hemorrhoids were banded. On average, the male patients had been experiencing symptoms of 9 years, while the female patients had been experiencing the symptoms for 8.9 years. On average, treatments consisted of 3.4 session and 3.6 rubber band ligations.
Multiple sessions were required with advanced grades of hemorrhoids
100% of Grade II hemorrhoids patients required multiple sessions
94% of Grade III hemorrhoids patients required multiple sessions
7 patients only required one session (66.7% had Grade I hemorrhoids)
65 patients had no short-term or long-term complications
9 patients had short-term tenesmus (the feeling of needing to pass stools) for an hour after the procedure
2 patients experienced bleeding 2 weeks after the procedure which cleared up on its own
5 patients required additional rubber band ligations during a follow-up visit
3 patients required trimming surgery during follow-up; this is also done as an outpatient procedure
Conclusion: 90% of patients were able to achieve symptom relief with the modified Barron method and complications were minor. In addition, this treatment option had the benefit of being performed in an outpatient setting and allowed patients to immediately return to normal activity levels. Plus, no anesthesia is required and the procedure allows for a 6 to 12 month follow-up period. The doctors determined that the modified Barron method was a good treatment option for hemorrhoids.