Comparative Analysis Of Perioperative Efficacy Of RPH,TST And MMH In Treatment Of Mixed Hemorrhoids

Objective: This study compared various surgical and perioperative parameters of patients treated with the Ruiyun procedure for hemorrhoids(RPH),the Tissue-selecting Therapystapler(TST),and the Milligan-Morgan hemorrhoidectomy(MMH).The safety of the three procedures in the perioperative period for the treatment of stage III and IV mixed hemorrhoids and the advantages of each of the three procedures were evaluated by using various surgical and perioperative indicators.Methods: Patients who underwent stage III and IV mixed hemorrhoid surgery from September 2018 to November 2019 at Xinhua Hospital of Dalian University were selected,of whom 86 patients underwent RPH surgery,of whom 76 patients underwent TST surgery,and 78 patients underwent conventional surgery.The patients were observed and counted for the operation time,average hospital days,length of wound healing,and pain scores at 6 hours,3 days,and 7 days postoperatively for each of the three surgeries.The incidence of postoperative complications was also compared between patients who underwent TST surgery or RPH surgery and those who underwent traditional external stripping and internal ligation,including the overall incidence of complications and the incidence of each specific complication(such as postoperative pain,postoperative bleeding,difficulty in defecation,fecal incontinence,urinary retention,postoperative incision that did not heal,perianal discomfort,anal stricture,postoperative bleeding from denudation,rectovaginal fistula,etc.)SPSS 23.0 software was used to statistically test each index,and the chi-square test and t-test were used to statistically analyze whether there was statistical significance for the count data and the measurement data,respectively.And then the statistically significant indicators were included in the logistic regression for correction to make the results of this study more accurate.Results: Compared with patients in the MMH surgery group,patients in the RPH and TST surgery groups took less time to operate,and the healing of patients’ postoperative wounds was significantly faster,while there was no significant difference in the average postoperative hospital stay.At the same time,patients had significantly less postoperative pain.The overall postoperative complication rate and the incidence of each specific complication(such as bleeding,postoperative urinary retention,delayed healing of the postoperative incision,postoperative bowel discomfort and the presence of anal swelling)were significantly lower.In addition,patients in the RPH,TST,and external stripping and internal ligation groups did not suffer from serious complications such as bleeding from denudation,rectovaginal fistula,or postoperative anal stricture.And after logistic regression analysis,the four indicators of patients’ overall time spent in surgery,patients’ VAS score of pain on the 7th postoperative day,the insomnia rate on the night after surgery because of pain,and the postoperative complications remained statistically significant.Conclusion: For patients with stage III and IV mixed hemorrhoids,there was no significant difference in the number of days of hospitalization in the RPH and TST surgery group compared with the traditional external and internal ligation group,and there was relatively shorter operative time,less postoperative pain,less postoperative sleeplessness on the same night due to pain,and fewer postoperative and postoperative occurrences.In conclusion,the RPH and TST procedures have a more promising application compared with the traditional external peel and ligate procedure.