Clinical Research Of Severe Mixed Hemorrhoids Treated With RPH-4,External Hemorrhoidectomy And Internal Sphincterotomy

Objective:Through a comparative study,the purpose of this study was to explore the efficacy and advantages of RPH-4(Auto Elastic Thread Ligator For Hemorrhoids),external hemorrhoidectomy and internal sphincterotomy in the treatment of severe mixed hemorrhoids.Methods:From March 2019 to December 2020,126 patients with severe mixed hemorrhoids diagnosed by the Department of anorectal Medicine of the affiliated Hospital of North Sichuan Medical College were randomly divided into treatment group(RPH-4,external hemorrhoidectomy and internal sphincterotomy),control group A(RPH-4,external hemorrhoidectomy)and control group B(Milligan-Morgan Hemorrhoidectomy).The cure rate,operation time,intraoperative bleeding,postoperative pain,postoperative anal edema,postoperative urinary retention,anorectal stenosis and anal incontinence were observed,recorded,compared and analyzed.Results:There was no significant difference in intraoperative bleeding,postoperative bleeding(day 1,day 3,day 7)and anal incontinence among the three groups(P>0.05).There were significant differences in cure rate,operation time,postoperative urinary retention,postoperative bleeding(day 14),postoperative pain,postoperative anal edema,anorectal stenosis and wound healing time among the three groups(P<0.05).Conclusion:There was no statistical difference between the treatment group and control group A in terms of healing rate,operative time,postoperative urinary retention,postoperative pain(at first defecation,day 7),and postoperative bleeding(P>0.05).The treatment group compared to control group A resected the internal sphincter and was superior to control group A in terms of postoperative pain(on the same day),postoperative anal margin edema,anorectal stricture,and time to wound healing(P<0.05).The treatment group used RPH-4 compared to control group B.It achieved the goal of preserving the dentate line while reducing the surgical incision of external hemorrhoids and improved the healing rate by resecting the internal sphincter in order to release the internal sphincter spasm and improve the circulation.There was no statistical difference between the two groups in terms of operative time(P>0.05),in terms of postoperative urinary retention,postoperative bleeding(day 14),postoperative pain,postoperative anal margin edema,anorectal stricture,and wound healing time were significantly better in the treatment group than in control group B(P<0.05).Control group A applied RPH-4 compared to control group B.The cure rate was significantly higher than control group B.There was no statistical difference between the two groups in terms of postoperative bleeding,anorectal stenosis,and postoperative anal margin edema(P>0.05),and control group A was significantly better than control group B in terms of operative time,postoperative urinary retention,postoperative pain,and trauma healing time(P<0.05).Therefore,RPH-4,external hemorrhoidectomy with internal sphincterotomy deserves clinical promotion.