Clinical Study On The Effect Of Mixed Hemorrhoidectomy Combined With Lateral Internal Sphincter Incision And Flap Transfer On Anal Function In Patients With Circular Hemorrhoids

Objective: To explore the effect of mixed hemorrhoidectomy + lateral anal sphincterotomy + local anal flap transfer on anal function in patients with annular mixed hemorrhoidectomy.Methods: This study is a retrospective study.120 patients with circular mixed hemorrhoids were selected to be treated in our hospital through the medical records.The patients were admitted from January 2020 to January 2023.According to the treatment plan,they were divided into three groups: Group A,Group B and Group C.Group A patients were treated with mixed hemorrhoid resection,and Group B patients were treated with mixed hemorrhoid resection+internal anal sphincter lateral resection,Group C patients were treated with mixed hemorrhoidectomy+lateral resection of anal sphincter+local anal flap transfer.Compare and analyze the general clinical data,treatment response rate,degree of pain and perianal edema,quality of life score,wound healing time and pain relief time,anal function,anal stenosis score,defecation status,wound exudate,granulation tissue score,sleep quality index scale score,incidence of adverse reactions,and recurrence rate of three groups of patients.Results:(1)There were no statistically significant differences in gender,age,BMI index,duration of disease,size of traumatic area,intraoperative and postoperative fluid volume among the three groups,which were comparable(P>0.05).(2)The total effective rate was 80.00% in group A,90.00% in group B,and 97.50%in group C,with statistical significance(P<0.05).(3)After 14 days of treatment,the pain degree and perianal edema of the three groups were decreased on average,and the pain degree and perianal edema score of the C group were the lowest(P<0.05).(4)The quality of life score of group C was significantly higher than that of groups A and B,while the wound healing time and pain relief time of group C were significantly lower than those of groups A and B(P<0.05).(5)After treatment,the length of the high pressure zone of the anal canal in all three groups was shortened,and the length of the high pressure zone of the anal canal,the diastolic pressure of the anal canal and the maximum systolic pressure of the anal canal were increased(P<0.05).The length of the high pressure zone of the anal canal in group C was shorter than that in group A and group B,and the resting pressure of the anal canal,the diastolic pressure of the anal canal and the maximum systolic pressure of the anal canal were all higher than those in group A and group B(P<0.05).(6)On the 14 th day after treatment,scores of scores of anal stricture,frequency of stool,difficulty of stool,unclean emptying,abdominal pain,defecation time,assisted defecation and defecation failure in three groups were significantly lower than before treatment(P<0.05).(7)On the 14 th day after treatment,wound exudate score in 3 groups was significantly lower than before treatment(P<0.05),and wound exudate score in group C was significantly lower than that in groups A and B(P<0.05).(8)On day 14 after treatment,the granulation tissue score of 3 groups was significantly lower than before treatment(P<0.05),and the granulation tissue score of group C was significantly lower than that of groups A and B(P<0.05).(9)After treatment,the scores and total scores of PSQI in group C were lower than those in groups A and B(P<0.05).(10)The total incidence and recurrence rate of adverse reactions in group C were significantly lower than those in groups A and B(P<0.05).Conclusion: Mixed hemorrhoidectomy + lateral anal sphincterotomy + local anal flap transfer can significantly improve the anal function of patients with annular mixed hemorrhoidectomy,promote the recovery of patients,and is worthy of clinical application.