Comparison of the outcomes of hemorrhoidectomy and PPH in the treatment of grades III and IV hemorrhoids

Abstract

To investigate the clinical effect and outcome of traditional hemorrhoidectomy and procedures for prolapse and hemorrhoid (PPH) for the treatment of grades III and IV hemorrhoids.We retrospectively reviewed 1003 grades III and IV hemorrhoid patients who presented to our hospital. A total of 585 patients underwent PPH, and 418 patients underwent hemorrhoidectomy. The outcomes were 1-year recurrence, postoperative complications, surgery-related complications, and indicators.No significant difference between the 2 treatment groups regarding patient demographics. All patients underwent more than 12 months of postoperative follow-up. No significant difference between the 2 treatment groups in 1-year recurrence. PPH can markedly improve anal pain, postoperative bleeding, difficult urination, and postoperative resting anal pressure. The operative blood loss, operative time, wound healing time, and wound infection rates were decreased significantly in the PPH group compared with the traditional hemorrhoidectomy group.Our data suggest that PPH is useful and safe for grades III and IV hemorrhoids. It can reduce postoperative and surgery-related complications. However, this was a single-hospital retrospective study. Therefore, well-designed, multicenter, randomized controlled trials are needed to evaluate the value of PPH for grades III and IV hemorrhoids.Abbreviations: PPH = procedures for prolapse and hemorrhoid, RAP = resting anal pressure.

Prevention of Rectal Stenosis After Procedure for Prolapse and Hemorrhoids by Anastomotic Thread-Drawing and Anal Enlargement

“…The amount of thread hanging is mainly based on the comprehensive measurement of the degree of stenosis and hardness of the scar tissue. 10 Compared with direct incision of the stenosis ring, there was less bleeding after the stenosis ring was set in the treatment of rectal stenosis after PPH. 11 At the same time, slow cutting can prevent re-adhesive stenosis of the severed end of the stenosis ring.…”

Traditional Chinese Medicine in the treatment of hemorrhoids—a review of preparations used and their mechanism of action

“…Jia et al (2023) found that Xileisan temperature-sensitive gels could reduce inflammation and bleeding in the hemorrhoid mucosa in rats, possibly related to the inhibition of eNOS expression in the rat's hemorrhoid tissues. Zhang (2015a) found that Sihuang Hemorrhoids Ointment could improve local symptoms in a rat model of hemorrhoids, possibly related to the inhibition of iNOS expression. Zhang (2017b) found that the modified Huanglian Jiedu Decoction could reduce local inflammation in a rat model of hemorrhoids, improve edema and ulcer symptoms in the perianal area, and its mechanism of action might be related to the inhibition of iNOS expression.…”

“…Zhao (2013) found that Sanhuang Zhixue Capsule could significantly inhibit the expression of VEGF in the rat's rectal canal. Zhang (2015a) found that Si Huang Hemorrhoid Ointment could significantly inhibit the expression of VEGF in animal models of hemorrhoids using immunohistochemistry. Jia et al (2023) found that Xileisan temperature-sensitive gels could alleviate inflammation and reduce internal hemorrhoid bleeding possibly by inhibiting the expression of VEGF-A in rat hemorrhoid tissues.…”

Hemorrhoidal Disease: How to Proceed After Unsuccessful Medical Treatment?

“…The most frequent post-operative issue is pain, but anal stricture and incontinence, albeit rare, may result from excessive tissue removal and damage to the sphincter muscles [66,68]. These can be avoided by retaining normal anoderm between excisions, not excising all hemorrhoid sacs at once for patients with extensive lesions, and performing careful dissection in the submucosal plane [69].…”