To investigate the safety and clinical efficacy of the suprahemorrhoidal mucosal surgical exposure aid (Patent No. ZL201822134366.4) with freely adjustable opening ring in hemorrhoidal anastomosis surgery.

A retrospective cohort study was conducted to include 104 patients with mixed hemorrhoids who underwent selective suprahemorrhoidal mucosal resection and external hemorrhoidectomy from March 2020 to June 2020 in the First Department of Anoenterology, People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine. These patients were divided into 52 cases for free variable stapling (free group) and 52 cases for traditional stapling (control group) according to the different types of intraoperative stapling. The general data, recent and long-term outcomes of the two groups were analyzed and compared.

Both groups of enrolled cases were successfully completed the surgery. There was no statistically significant difference in the comparison of general data between the two groups (P＞0.05). In the comparison of short-term efficacy, the incidence of postoperative acute bowel sensation in the free group was lower than that in the control group (9.6% vs. 26.9%, χ²=5.216, P=0.022). There was no statistically significant difference in the comparison of the duration of surgery, the amount of intraoperative bleeding, the average postoperative pain score, the secondary massive bleeding (more than 200 mL), postoperative urinary retention, and the number of postoperative hospital stay between the two groups (P＞0.05). In the long-term efficacy comparison, the incidence of postoperative anal distension in the free group was lower than that in the control group (5.8% vs. 19.2%, χ²=4.038, P=0.038). The two groups had no statistical difference in the evaluation and comparison of curative effect (P=0.3).There was no statistically significant difference in the 1-year recurrence rate between the two groups (χ²=0.210, P=0.647), and there was no statistically significant difference in the comparison of postoperative anal stenosis (χ²=1.040, P=0.308) and incontinence (P=1.0) between the two groups.

The use of the suprahemorrhoidal mucosal surgical exposure aid with freely adjustable opening ring in hemorrhoidal anastomosis surgery is safe and effective, and can achieve good near-term and long-term results with a lower incidence of postoperative urgency and anal swelling, and is suitable for further clinical promotion.