SOP Ligatur von Hämorrhoiden

Die Hämorrhoidenligatur ist seit vielen Jahren das Standardverfahren zur Behandlung symptomatischer Hämorrhoiden II. Grades. Sie wird meistens ambulant durchgeführt, ist wenig aufwendig, gut und rasch zu erlernen und erfordert wenig Ausrüstung. Gelegentlich treten allerdings Komplikationen auf, die man kennen muss.

Schlüsselwörter

Hämorrhoiden - Hämorrhoidenligatur - Indikationen - Kontraindikationen - Komplikationen

• Literatur

• 1 Joos AK, Arnold R, Borschitz T. et al. S3-Leitlinie Hämorrhoidalleiden. AWMF-Registernummer 081–007. April 2019. Im Internet (Stand: 27.04.2021): http://www.awmf.org/leitlinien/detail/ll/081-007.html
• 2 van Tol RR, Kleijnen J, Watson AJM. et al. European Society of Coloproctology: Guideline for haemorrhoidal disease. Colorectal Dis 2020; 22: 650-662
• 3 Davis BR, Lee-Kong SA, Migaly J. et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of hemorrhoids. Dis Colon Rectum 2018; 61: 284-292
• 4 Alonso-Coello P, Guyatt G, Heels-Ansdell D. et al. Laxatives for the treatment of hemorrhoids. Cochrane Database Syst Rev 2005; (04) CD004649
• 5 Garg P. Why should a good proportion of hemorrhoids not be operated on? – Letʼs TONE up. Dis Colon Rectum 2016; 59: 583-585
• 6 Garg P, Singh P. Adequate dietary fiber supplement and TONE can help avoid surgery in most patients with advanced hemorrhoids. Minerva Gastroenterol Dietol 2017; 63: 92-96
• 7 Jacobs D. Clinical Practice. Hemorrhoids. N Engl J Med 2014; 371: 944-951
• 8 Nelson RS, Ewing BM, Ternent C. et al. Risk of late bleeding following hemorrhoidal banding in patients on antithrombotic prophylaxis. Am J Surg 2008; 196: 994-999 discussion 999
• 9 Iyer VS, Shrier I, Gordon PH. Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal hemorrhoids. Dis Colon Rectum 2004; 47: 1364-1370
• 10 Wienert V. Schwerwiegende Komplikationen nach Gummiringligatur von Hämorrhoiden. Coloproctol 2006; 28: 224-226
• 11 MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 1995; 38: 687-694
• 12 Jensen SL, Harling H, Arseth-hansen P. et al. The natural history of symptomatic haemorrhoids. Int J Colorectal Dis 1989; 4: 41-44
• 13 Brown SR, Tiernan JP, Watson AJM. et al. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial. Lancet 2016; 388: 356-364
• 14 Murie JA, Sim AJ, Mackenzie I. Rubber band ligation versus haemorrhoidectomy for prolapsing haemorrhoids: a long term prospective clinical trial. Br J Surg 1982; 69: 536-538
• 15 Shanmugam V, Muthukumarasamy G, Cook JA. et al. Randomized controlled trial comparing rubber band ligation with stapled haemorrhoidopexy for Grade II circumferential haemorrhoids: long-term results. Colorectal Dis 2010; 12: 579-586
• 16 Shanmugam V, Thaha MA, Rabindranath KS. et al. Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev 2005; (01) CD005034
• 17 Gartell PC, Sheridan RJ, McGinn FP. Out-patient treatment of haemorrhoids: a randomized clinical trial to compare rubber and ligation with phenol injection. Br J Surg 1985; 72: 478-479
• 18 Kanellos I, Goulimaris I, Christoforidis E. et al. A comparison of the simultaneous application of sclerotherapy and rubber band ligation, with sclerotherapy and rubber band ligation applied separately, for the treatment of haemorrhoids: a prospective randomized trial. Colorectal Dis 2003; 5: 133-138