Procedure for prolapse and hemorrhoids vs traditional surgery for outlet obstructive constipation

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Outlet obstruction-induced constipation is often associated with internal rectal prolapse and circumferential hemorrhoids.
• Surgical intervention is frequently required to address these complex conditions.

Purpose of the Study:

• To compare the clinical efficacy of the procedure for prolapse and hemorrhoids (PPH) against conventional surgery for patients with rectal prolapse and hemorrhoids causing outlet obstruction-induced constipation.
• To evaluate both short-term and long-term outcomes of each surgical approach.

Main Methods:

• A prospective study involving 108 inpatients with rectal prolapse hemorrhoids and outlet obstruction-induced constipation.
• Patients were randomly assigned to either the PPH group (n=54) or a conventional surgery control group (n=54).
• Clinical effects, including operative time, hospital stay, postoperative complications (urinary retention, edema, pain, stenosis, incontinence), and long-term functional outcomes (recurrence, defecation difficulty), were compared.

Main Results:

• The PPH group demonstrated significantly shorter operative times (24.36 min vs 44.27 min) and hospital stays (2.1 d vs 3.6 d) compared to the control group (P < 0.01).
• PPH surgery resulted in significantly lower incidences of perianal edema (11.11% vs 42.60%, P < 0.05) and sensory anal incontinence (3.70% vs 12.96%, P < 0.05).
• Pain scores were significantly lower in the PPH group at 24 hours, first defecation, and one week post-surgery (P < 0.01).

Conclusions:

• The procedure for prolapse and hemorrhoids (PPH) is clinically superior to traditional surgery for managing outlet obstructive constipation stemming from internal rectal prolapse with circumferential hemorrhoids.
• PPH offers advantages in terms of reduced operative time, shorter hospital stay, and lower rates of postoperative perianal edema and sensory anal incontinence.