Abstract:

Objective To compare and analyze the clinical efficacy of tissue-selecting therapy stapler (TST) and low anastomosis combined with latent dissection and Ruiyun procedure for hemorrhoid (RPH) combined with external dissection and internal ligation in the treatment of stage Ⅳ mixed hemorrhoids. Method 75 patients with stage Ⅳ mixed hemorrhoids treated in Yixing Fourth People's Hospital from January to December 2020 were randomly divided into observation group (40 cases) and control group (35 cases). The patients in the observation group were treated with TST and low anastomosis combined with latent dissection, and the patients in the control group were treated with RPH combined with external dissection and internal ligation. The intraoperative indexes, recovery indexes, complication rate, curative effect and recurrence rate were compared between the two groups. Result The amount of bleeding and operation time in the observation group were less than those in the control group (P ＜ 0.05). The incidence of postoperative anal edema in the observation group was less than that in the control group (P ＜0.05), but there was no significant difference in the incidence of postoperative bleeding, anal distension and incision infection between the two groups (P ＞ 0.05). There was no significant difference in the total effective rate and recurrence rate between the observation group and the control group (P ＞ 0.05), but the cure rate of the observation group was higher than that of the control group (P ＜ 0.05). Conclusion for patients with stage Ⅳ mixed hemorrhoids, the clinical efficacy of TST low anastomosis combined with latent dissection is equivalent to that of RPH combined with external dissection and internal ligation. However, TST low anastomosis combined with latent dissection has the advantages of small injury, light pain, rapid postoperative recovery, low incidence of edema and high cure rate.

Key words: Mixed hemorrhoids, Tissue-selecting therapy stapler, ruiyun procedure for hemorrhoid, External stripping and internal ligation, Stealth dissection, Curative effect