Global knowledge mapping and technological evolution in hemorrhoid therapy: a multi-tool bibliometric analysis

Hemorrhoidal disease imposes a significant global healthcare burden. However, comprehensive analyses mapping its research landscape and technological evolution are lacking. This study employed advanced bibliometric techniques to characterize the knowledge structure, collaborative networks, research hotspots, and emerging trends in hemorrhoid therapy over the past two decades. A total of 2764 relevant publications were retrieved from the Web of Science Core Collection (WoSCC). Multi-tool bibliometric analysis and scientific visualization were conducted using VOSviewer (v1.6.19), CiteSpace (v6.2.R4), and Bibliometrix (v4.1.3). Analyses included publication trends, country/institutional contributions, author/institutional collaboration networks, journal co-citation analysis, keyword co-occurrence/clustering, thematic evolution, and burst detection. Annual publications showed a steady increase, signifying growing research interest. China and the United States were the dominant contributors. International collaboration networks displayed regional clustering. Core research domains identified through keyword co-occurrence and clustering included Rubber Band Ligation (RBL), hemorrhoidectomy (Milligan-Morgan, Ferguson, stapled), laser therapy, pain management, postoperative complications, and quality of life. Burst detection and thematic evolution mapping highlighted emerging frontiers such as minimally invasive techniques (Doppler-guided hemorrhoidal artery ligation [DG-HAL], laser hemorrhoidoplasty), day surgery/ambulatory management, evidence-based guidelines, and long-term outcomes/comparative effectiveness. This first multi-tool bibliometric analysis comprehensively delineates the global research architecture and dynamic evolution of hemorrhoid therapy. It confirms the established role of conventional surgical techniques while identifying a clear shift towards minimally invasive procedures and outpatient management. Key knowledge gaps persist in long-term efficacy comparisons and standardized guideline development. These findings provide researchers, clinicians, and policymakers with an evidence-based roadmap to guide future investigations, resource allocation, and clinical practice optimization in hemorrhoidal disease management.