Clinical Study Of PPH Combined With High Multi-point Suspension In The Treatment Of Mixed Hemorrhoids With Internal Rectal Prolapse

Objective:To analyze the clinical efficacy of Procedure for prolapse and hemorrhoids(PPH)combined with high multi-point suspension in the treatment of mixed hemorrhoids with internal rectal prolapse.Methods:A prospective cohort study was conducted in 80 patients of mixed hemorrhoids complicated with intrarectal prolapse who met the inclusion criteria in our hospital from December 2018 to October 2019.PPH combined with high multi-point suspension was used in the observation group,and PPH was used in the control group,with 40 cases in each group.The discharge effect,short-term indexes(operative time,hospital stay,postoperative urinary retention,postoperative perianal edema,postoperative pain)and follow-up indexes(postoperative anal stenosis,postoperative anal incontinence,postoperative anal tenesmus,postoperative sensation of incomplete evacuation,postoperative residual skin tags,postoperative recurrence)were compared between the two groups.Results:In terms of postoperative short-term indexes,the visual analogue scale scores on the first day after surgery,first defecation and the incidence of perianal edema in the observation group were significantly lower than those in the control group(3.28 ±0.64 vs 3.68±1.00,4.00±1.06 vs 4.70±0.97,and 10.0%vs 27.5%,respectively,all P<0.05).There was no significant difference in operative time,hospital stay,the incidence of urinary retention and visual analogue scale score on the seventh day after surgery between the two groups(33.15±9.59min vs 30.13±9.44min,9.15±2.68d vs 9.00±2.32d,17.5%vs 22.5%,2.23±0.58 vs 2.45±0.71,respectively).With regard to postoperative follow-up indexes,the incidence of sensation of incomplete evacuation in the observation group were significantly lower than those in the control group(5.0%vs 22.5%,P<0.05).There was no significant difference in the incidences of anal stenosis,anal incontinence,anal tenesmus,residual skin tags and recurrence between the two groups(7.5%vs 15.0%,2.5%vs 5.0%,17.5%vs 27.5%,7.5%vs 12.5%,0%vs 0%,respectively).There was no significant difference in the efficacy of discharge between the two groups,and the effective rate in both groups was 100%.Conclusion:Compared with PPH,PPH combined with high multi-point suspension in the treatment of mixed hemorrhoids with internal rectal prolapse has less postoperative pain,lower incidence of perianal edema and sensation of incomplete evacuation,which is the optimal operation and is worthy of further clinical application.