To observe the clinical effect of the treatment of grades Ⅲ~Ⅳ prolapsing hemorrhoids with conformal resection of procedure for prolapse and hemorrhoids.

A retrospective cohort study was conducted. From January 2019 to January 2020, patients with grade III~IV circumferential prolapsing hemorrhoids who were diagnosed and operated in the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University were collected. According to different surgical methods, the patients were divided into conformal resection group and traditional procedure for prolapse and hemorrhoids (PPH) group. The operation related indexes and postoperative complications within 1 year of the two groups were retrospectively analyzed and compared.

A total of 275 patients met the inclusion criteria. 77 patients received conformal resection and 198 patients received traditional PPH. There was no significant difference in gender, age, course of disease and grades of hemorrhoids between the two groups. The intraoperative blood loss (Z=-6.472, P＜0.01) and 24 h postoperative pain score (t=-5.152, P＜0.01) in the conformal resection group were significantly lower than those in the traditional PPH group, and the operation time (mean 35.2 vs. 31.9 min, t=-2.871; P=0.004) was slightly longer than that in the traditional PPH group. However, there was no significant difference in hospitalization days (t=-0.467, P＞0.05) and hospitalization expenses (t=1.141, P＞0.05) between the two groups (P＞0.05). The overall incidence of postoperative complications in the conformal resection group was significantly lower than that in the traditional PPH Group [9.1%(7/77) vs. 35.8%(71/198), χ²=19.55; P=0.000], in which postoperative recurrence [2.6%(2/77) vs. 10.1%(20/198), χ²=4.241; P=0.039] was significantly lower than that of the traditional PPH group, and there was no significant difference between the two groups in the complications of moderate anal stenosis and degree II anal incontinence (P＞0.05), but the conformal resection group of mild anal stenosis was significantly lower than that of the traditional PPH Group [1.3% (1/77) vs. 8.1%(16/198), χ²=3.305; P=0.069], and the conformal resection group of degree I anal incontinence was significantly lower than that of the traditional PPH Group [0% (0/77) vs. 7.1%(14/198), χ²=4.366; P=0.037]. There was no significant difference in postoperative chronic pain (P＞0.05), postoperative bleeding (P＞0.05), perianal secretion (χ²=0.870,P＞0.05) and anal distension (χ²=0.010,P＞0.05) between the two groups (P＞0.05). There were no complications of postoperative bleeding, postoperative chronic pain and anal incontinence in the conformal resection group.

Conformal resection of procedure for prolapse and hemorrhoids is safe and effective for the treatment of III~IV prolapsing hemorrhoids, with less postoperative pain, lower postoperative complications and recurrence rate, which is worthy of clinical application.