Optimizing circumferential prolapsed hemorrhoid surgery: Transverse incision with longitudinal ligation procedure delivers superior radicality compared to Milligan-Morgan technique.

BACKGROUND

Circumferential prolapsed hemorrhoids (CPHs) necessitate surgical intervention. While Milligan-Morgan hemorrhoidectomy (MMH) remains widely used, it compromises functional preservation and associates with significant postoperative pain, edema, and delayed healing in severe CPH cases. To address these limitations, our research team innovatively proposed the transverse incision with longitudinal ligation procedure (TILL). This novel technique utilizes targeted transverse incisions and longitudinal pedicle ligation to optimize complete resection while preserving anal anatomy and function.

AIM: To optimize CPH resection and anal function preservation through comparative efficacy-safety evaluation of TILL vs MMH.

METHODS

A total of 180 patients were retrospectively reviewed in China. The patients were divided into two groups of 90 based on the surgical methods. The treatment group underwent the TILL procedure, while the control group underwent MMH. The main observation index was the evaluation of clinical efficacy after wound healing. Secondary outcomes included the recurrence rate and wound healing time. Safety measurements were also evaluated.

RESULTS

The TILL group showed a significant difference compared to the MMH group (P = 0.022), indicating better overall treatment effects. The time for wound healing in the TILL group was shorter than that in the MMH group (P = 0.001). Compared to those who underwent MMH, those who underwent TILL experienced significantly reduced postoperative pain, with lower average scores for anal edema and anal stenosis (both P < 0.05).

CONCLUSION

TILL demonstrates superior efficacy to MMH for advanced CPH, reducing recovery times and postoperative pain, edema, and stenosis while preserving anal function.