To compare the efficacy of tissue-selecting therapy stapler (TST) and procedure for prolapse and hemorrhoids (PPH) in the treatment of severe mixed hemorrhoids.

The clinical data of 108 patients with severe mixed hemorrhoids admitted to Shunyi Hospital of Beijing Hospital of Traditional Chinese Medicine from June 2018 to June 2019 were collected. The patients were divided into either TST group (59 cases) or PPH group (49 cases) according to surgical methods used. The amount of intraoperative blood loss, operative time, pain degree 24 h after surgery, postoperative hospital stay, treatment effect, postoperative complications and recurrence were compared between the two groups.

The amount of intraoperative blood loss in the TST group [(29.23±9.64) ml] was significantly less than that in PPH group [(38.54±3.92) ml; P=0.026]. The operative time [(31.36±10.45) min] and hospital stay [(5.25±1.83) d] in the TST group were significantly shorter than those in the PPH group [(35.04±9.37) min and (6.24±1.49) d, respectively; P=0.021 and 0.012, respectively]. There was no significant difference in postoperative pain score between the two groups [(4.32±1.41) points vs (5.94±1.74) points, P=0.053]. In terms of treatment effect, there was no significant difference in the total effective rate between the two groups (94.9% vs 89.8%, P=0.072). Compared with the PPH group, the symptoms of anal pain, anal stenosis, and hematochezia in the TST group were significantly milder (P＜0.05 for all). The 1-year recurrence rate in the TST group was significantly lower than that in the PPH group (8.7% vs 11.6%, P=0.042). There was no significant difference in the 2-year recurrence rate between the two groups after surgery (18.4% vs 20.0%, P=0.068).

TST and PPH have similar long-term effects in the treatment of severe mixed hemorrhoids, but under the same conditions, TST is associated with less intraoperative blood loss, shorter duration of operation and hospitalization, and minor complications, which is worthy of clinical promotion.