A Clinical Study On The Effect Of Segmented Internal Sphincterotomy Combined With Longitudinal Incision And Transverse Suture On Anal Function In Patients With Circular Mixed Hemorrhoids

Ojective: The purpose of this study is to observe the changes of anal function of patients with circular mixed hemorrhoids before and after operation,and to analyze and compare the effects of segmented internal sphincter resection combined with longitudinal transverse suture and traditional external stripping and internal ligation on anal function of patients from multiple perspectives,combined with the relevant indicators of anorectal motility.At the same time,the clinical effects of the two kinds of operation were compared in order to find an operation method which is safe and reliable and pays attention to the protection of anal function.Methods: In this study,60 inpatients who met the inclusion criteria were randomly divided into treatment group and control group,30 cases each.The treatment group was treated by segment cutting internal sphincter combined with longitudinal transverse suture,and the control group was treated by traditional external exfoliation and internal ligation.The overall curative effect,postoperative complications,postoperative anal function,relevant indexes of rectal anal pressure measurement,wound healing time and residual condition of skin were observed and compared between the two groups.Results: 1.There was no statistical difference in the overall curative effect between the two groups.2.Postoperative complications: There was no significant difference between the two groups in terms of postoperative hemorrhage and urinary retention.There was no significant difference in pain 6 hours after operation,but there was significant difference in pain 1 day,3 days,5 days and 7 days after operation.The difference of perianal edema on the 3rd day,7th day and 2nd week after operation was statistically significant.There was a significant difference in the feeling of anal distension 2 weeks after the operation,and no statistical difference in the feeling of anal distension 3 months after the operation.3.Postoperative anal function: There was no significant difference in anal incontinence scores between thetwo groups 2 weeks and 3 months after operation.There was no significant difference in anal stenosis score,CSS score and self-designed score of defecation patency degree at 2 weeks and 3 months after operation.4.Indicators related to the measurement of rectal and anal pressure:(1)intra-group comparison: the maximum anal systolic blood pressure and anal function length of the two groups 3 months after surgery were statistically insignificant compared with those before surgery.The difference of anorectal resting pressure in the treatment group 3 months after surgery was statistically significant compared with that before surgery,while the control group had no statistical significance.(2)comparison between groups: there was no significant difference in the maximum systolic pressure of anal canal and the functional length of anal canal between the two groups 3 months after operation;There was significant difference in resting pressure of anal canal 3 months after operation.5.There was no significant difference in wound healing time and residual skin between the two groups.Conclusion:Both groups had good curative effect;however,the segmented internal sphincter resection combined with longitudinal transverse suture has obvious advantages in reducing postoperative complications,shortening wound healing time and reducing redundant skin residue,especially in the protection of anal function,which is worthy of clinical application.