MODIFIED HEMORRHOIDECTOMY WITH SUBMUCOSAL IMMERSION OF VASCULAR PEDICLE STUMPS IN COMPLICATED HEMORRHOIDS: CLINICAL OUTCOMES AND INDICATIONS
DOI:
https://doi.org/10.5281/zenodo.19107433Keywords:
complicated hemorrhoids, hemorrhoidectomy, submucosal immersion, vascular pedicle stumps, posthemorrhagic anemia, thrombosed hemorrhoids, postoperative complications, anal canal stricture, anal sphincter insufficiency, coloproctology.Abstract
Complicated forms of hemorrhoids, including posthemorrhagic anemia, stage IV chronic hemorrhoids with permanent prolapse of internal nodes and rectal mucosa, and grade III thrombosed hemorrhoids, represent some of the most demanding clinical entities in coloproctological surgery. Traditional closed hemorrhoidectomy (Milligan–Morgan modification II), although widely employed, is associated with a significant burden of early and late postoperative complications attributable largely to the retention of vascular pedicle stumps within the anal canal and the extensive resection of anal canal mucosa. This prospective study was conducted at the Proctology Department of Samarkand State Medical University Clinic between 2019 and 2024, enrolling 346 patients with complicated hemorrhoids. The study group (n = 176) underwent a novel modified hemorrhoidectomy technique, while the control group (n = 170) received traditional closed hemorrhoidectomy. The two groups were comparable in age (mean 42.35 ± 0.662 versus 41.92 ± 0.653 years), sex distribution (62.1% versus 62.2% male), and clinical presentation.
