Ano-rectal physiological changes after rubber band ligation and closed haemorrhoidectomy.
OBJECTIVE
The effect of treatment for haemorrhoids on ano-rectal physiology was studied in a prospective longitudinal follow-up study.


METHODS
Thirty-six consecutive patients having II-III degree (Group I, 18 patients) or IV degree (Group II, 18 patients) haemorrhoids were studied. Group I underwent rubber band ligation while Group II underwent closed scissors haemorrhoidectomy.


RESULTS
Patients in Group I had significantly lower maximum basal pressure (P < 0.05) and also significantly lower maximum squeeze pressure (P < 0.05) compared to Group II before treatment. Both basal and squeeze pressures dropped after haemorrhoidectomy (P < 0.001) whereas they remained unchanged after rubber band ligation (P > 0.1). The volume of first sensation was higher in Group II before treatment (P < 0.001) and remained so after treatment. Rectal compliance was higher (P < 0.005) in Group I before treatment. It increased significantly in both groups (P < 0.05, Group I; P < 0.001, Group II) after treatment.


CONCLUSIONS
The results show a significant increase in anal pressures in constantly prolapsing (IV degree) haemorrhoids. Most of the physiological differences observed between the two groups were abolished after treatment. This suggests that these may be a consequence rather than a cause of haemorrhoids.
Bursics
A
A
First Department of Surgery, Semmelweis University, Budapest, Hungary. bu@seb1.sote.hu
Weltner
J
J
Flautner
L E
LE
Morvay
K
K
D000368:Aged; D001003:Anal Canal / Q000502:physiology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006484:Hemorrhoids / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008026:Ligation / Q000379:methods; D008365:Manometry; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome