Treatment Result of the Mucopexy-Recto Anal Lifting Method for Hemorrhoids in Comparison with Ligation and Excision, and Aluminum Potassium Sulfate and Tannic Acid Sclerotherapy

Abstract

The outcomes of Mucopexy-Recto Anal Lifting (MuRAL) in hemorrhoid surgery were compared with ligation and excision (LE), and aluminum potassium sulfate and tannic acid sclerotherapy (ALTA). In this study, we conducted a 3-year follow-up study of MuRAL (380 cases) and compared it with LE (1417 cases) and ALTA (541 cases) performed at the same period. Operative time, mean hospital stay, postoperative pain, postoperative complications, and recurrence were compared and examined retrospectively. The mean operative time was the longest for MuRAL, followed by LE, and then ALTA at 29.1, 21.5, and 12.4 minutes, and the mean length of hospital stay was 6.2, 10.6, and 1.3, days, respectively. Based on the frequency of injectable analgesic use, postoperative pain was clearly milder in MuRAL and ALTA than in LE. The recurrence rates were 3.2% with MuRAL, 1.1% with LE, and 12.4% with ALTA. Early postoperative low-grade fever and bowel movement urgency were observed in all surgeries, but these were minor and did not pose a safety problem. LE is painful and requires prolonged hospitalization but is the most curative; ALTA is simple and can be performed as a day surgery but has a high recurrence rate. MuRAL was less painful than LE and had a lower recurrence rate than ALTA. In recent years, there have been various innovations in the surgical treatment of hemorrhoids, and choosing a technique that is appropriate for the condition of the hemorrhoid and patient's needs is necessary. MuRAL can be one of the options for hemorrhoid treatment as a "cure without cutting" method.

The short-term clinical outcomes of endoscopic rubber band ligation for grade I~III internal hemorrhoids

“…Multivariate analysis also found that suspension ligation was the protective factor for postoperative adverse events. These results are consistent with previous studies [15]. Therefore, suspension ligation can reduce the occurrence of postoperative adverse events, especially for severe prolapse of internal hemorrhoids.…”

“…The suspension ligation mentioned in this paper is a new ligation method based on above theory. By ligating the mucous membrane above the dentate line, the prolapsed anal cushion can move upward, as a result, the prolapse degree of internal hemorrhoids can be relieved and the incidence of postoperative adverse events such as bleeding, edema and pain et al, can be reduced [15]. In this study, we found that the proportion of using suspension ligation in grade III internal hemorrhoids group was signi cantly higher than that in grade I and II internal hemorrhoids groups, the postoperative adverse events was signi cantly lower than that in other two groups.…”