Management of internal hemorrhoidal disease by elastic ligation in Ouagadougou, Burkina Faso

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Résumé

Introduction: Hemorrhoidal disease is the leading cause of proctology consultations.
The management of internal hemorrhoids can be medical, instrumental,
and surgical. Instrumental treatment is a recent practice in Burkina
Faso. The aim of our study was to evaluate rubber band ligation of hemorrhoids
in Burkina Faso. Patients and method: This was a descriptive case series
study with retrospective data collection. It took place from January 1, 2021
to April 30, 2023 at the ILBOUDO BRUNO clinic. All patients with internal
hemorrhoidal disease, who had undergone hemorrhoid ligation, with a usable
medical record and a valid telephone contact, were included. Results: A total
of 107 patients underwent rubber band ligation. The mean age of the patients
was 42.8 years ± 13.16 years. The sex ratio was 3.1. The patients resided in
Ouagadougou at 84.1%. Hematochezia was the dominant symptom (83.2%).
Hemorrhoidal prolapse was grade II (23.3%) and grade III (15%). An anal fissure
was associated in 6.5% of patients. A ligation session was performed in
49 patients compared to 2 to 4 sessions for the other 58. The number of hemorrhoidal
bundles treated per session varied from 2 to 3. Elastic ligation of
hemorrhoids was effective for 86.5% of hematochezias and for 73.2% of hemorrhoidal
prolapses. Immediate complications were observed in 7.5% of cases,
such as anal pain. Fifteen patients experienced a recurrence, or 14%, within a
period of 3 to 6 months. Conclusion: Rubber band ligation is an effective technique. It must find a place and an indication here before surgery. It must be
developed and made accessible to patients in Burkina Faso.

Mots-clés

Rubber Band Ligation, Internal Hemorrhoidal Disease, Hematochezia, Hemorrhoidal Prolapse