Sintomatología y calidad de vida tras colocación de bandas hemorroidales para la patología hemorroidal (banding)

Résumé

Introduction: Haemorrhoidal disease is one of the most common benign disorders of the lower gastrointestinal tract that can have a significant impact on patients’ quality of life. Due to the current importance of an optimal quality of life, the treatment of this pathology aims to find methods to improve it. Banding is the most popular and effective office treatment for internal haemorrhoids. It is a relatively simple procedure with few complications. The main objective of this study was to assess the impact on quality of life after banding in patientes with symptomatic grade II-III haemorrhoids that do not respond to medical treatment, using quality of life scores. Material and methods: This was a prospective observational study where patients with haemorrhoidal disease and indication for banding were included between December 2019 and December 2020. This procedure was performed in the General and Digestive Surgery outpatient clinics of the Ramón y Cajal University Hospital. The quality of life of was assessed by scores: HDSS (Hemorrhoidal Disease Symptom Score) and SHS (Short Health Scale), obtained by personal interview and telephone calls. Secondary objectives were: to assess the rate of patients who required one or more banding sessions; to establish their overall success rate and the percentage of patients who required other therapeutic measures; to identify risk factors associated with banding failure; and to analyse associated complications. Results: Regarding the impact on quality of life after banding, a significant reduction was found in the HDSS and SHS scores (p = 0.000). The main improvement was found in the first month and it was maintained until the sixth month. A high degree of satisfaction with the procedure was reported by 76% of patients. The overall success rate of banding was 89% at 18 months. A 12% complication rate was detected, the most frequent complication was severe anal pain (58.3%) and self-limiting bleeding (41.7%). Peripheral vascular disease was the risk factor which had a statistically significant association (p=0.02) with banding failure, in univariate analysis. Conclusion: Hemorrhoidal banding as a treatment for symptomatic grade II-III haemorrhoids that do not respond to medical treatment leads to a significant improvement in patients’ symptoms and quality of life. It also has a high degree of satisfaction between patients.