What are the common surgical options for hemorrhoids?

Currently, the main clinical surgical treatments include ring hemorrhoidectomy, external and internal hemorrhoidectomy and anastomotic suprahemorrhoidal mucosal stapling (PPH) and copper ion electrochemotherapy. This method is mainly used for internal hemorrhoids or mixed hemorrhoids with circular prominence. However, the disadvantage is that the operation lasts for a long time, there is a lot of postoperative bleeding, and 10%-13% of patients have serious complications, so it is rarely used now. The procedure was first proposed by Miles and modified in 1937 by Morgan at St. Mark’s Hospital in England, and is now the most commonly used clinical treatment for mixed hemorrhoids. Zhou Xiyang et al. used the modified segmental dentate ligation method to treat 156 cases of advanced internal hemorrhoids with circumferential mixed hemorrhoids and achieved good results, but the operation of this procedure is complicated, the invasion is large, the normal structure of the dentate line is damaged, the patient has obvious pain, and the postoperative bleeding is easy. The scarring of the anal canal after surgery is obvious, and the wound is prone to slow healing and long duration of pain, edema in the anal area, and in serious cases, anal stenosis or even anal incontinence. 3, clutch hemorrhoid circumferential stapling (PPH surgery) clutch hemorrhoid circumferential stapling is a newly emerged new method of treating severe prolapsed hemorrhoids. The procedure was first proposed and used by Dr. Longo in Italy, and was introduced in China in 2000 for the treatment of severe hemorrhoids. The operation is simple, painless after the operation, no anal stenosis, incontinence and other comorbidities, the recent effect is good, but this procedure is only applicable to patients with severe hemorrhoids, the indications are more limited and more expensive, and there are more limitations in applying to the treatment of clinical mixed hemorrhoids. 4, copper ion electrochemical treatment of internal hemorrhoids, through research has shown that its mechanism of action in the treatment of hemorrhoids are: (1) fibrous tissue formation, wrapped around or confined to the submucosal venous plexus (and arteries); if the copper needle is placed directly into the hemorrhoid body, fibrous tissue formation can play a role in supporting and protecting the layer, reducing the trauma to the venous plexus during fecal discharge, reducing bleeding; can also act on the venous plexus, blocking the lumen and leading to The occlusion of the vessels has a hemostatic effect from the point of view of hemostasis; if the copper needle acts at a higher site, in the supra-rectal mucosa, the formation of fibrosis will restrict and completely block the root of the supra-hemorrhoidal vein, while the supra-hemorrhoidal artery and its branches in the area of the hemorrhoid tip are blocked; therefore, the body of the hemorrhoid is atrophied. (2) The scar contracture of the fibrous tissue between the anal cushion and the rectal wall strengthens the support structure of the hemorrhoid and keeps the hemorrhoid fixed in the submucosal muscle layer so that it does not prolapse out of the anus during defecation. Copper ion electrochemical therapy is a minimally invasive and painful treatment, which is gradually being promoted in the clinical treatment of internal hemorrhoids, because it maintains the integrity of the anal cushion mucosa and allows it to play its proper role in the process of bowel control.