Ruiyun procedure for hemorrhoids versus tissue-selective therapy stapler for grade II–III hemorrhoids: an exploratory retrospective comparative study

The Ruiyun procedure for hemorrhoids (RPH) and tissue-selecting therapy (TST) are two widely adopted minimally invasive techniques for treating Grade II-III hemorrhoids. This study aims to perform an exploratory comparison of the efficacy and safety of these two surgical techniques within a real-world clinical setting, thereby providing evidence to inform future prospective investigations. A retrospective analysis was conducted on 192 patients with Grade II-III hemorrhoids, comprising 80 patients who underwent RPH and 112 who underwent TST. The primary outcomes were the treatment effectiveness rate at one month and the recurrence rate within one year postoperatively. Secondary outcomes included operative time, intraoperative blood loss, time to return to normal activities, postoperative anal pain, complication rates, patient satisfaction, and PROM scores. The two groups were comparable in baseline characteristics. No significant differences were found in the overall clinical efficacy or the one-year recurrence rate between the groups (p > 0.05). However, the RPH group demonstrated significant advantages, including shorter operative time, reduced intraoperative blood loss, faster return to normal activities, lower anal pain scores on postoperative days 1 and 3, a lower incidence of fecal urgency and higher patient satisfaction (all p < 0.05). No significant intergroup differences were observed in terms of anal distension, postoperative bleeding, anorectal stenosis, PROM scores, or anal pain on postoperative day 7 (p > 0.05). Within the context of this retrospective study, RPH demonstrated efficacy and safety in the treatment of Grade II–III hemorrhoids. It exhibited favorable outcomes in reducing intraoperative blood loss, shortening operative time, minimizing postoperative complications, and facilitating a rapid return to normal activities. However, given the potential differences in baseline characteristics between the two patient groups, these observations cannot be directly interpreted as evidence of the superiority or inferiority of either technique. The observed differences in efficacy may be partially attributable to disparities in patient selection.