Modified ultrasonic scalpel hemorrhoidectomy incorporating figure-eight closure versus conventional hemorrhoidectomy for mixed hemorrhoids: a randomized controlled trial

Hemorrhoidectomy remains the mainstay treatment for advanced mixed hemorrhoids; however, postoperative pain, delayed wound healing, and complications remain important concerns after surgery. This study aimed to evaluate the efficacy and safety of a modified ultrasonic scalpel hemorrhoidectomy incorporating figure-eight closure. This was a single-center, single-blind, randomized, parallel-controlled trial. A total of 78 patients with grade III–IV mixed hemorrhoids were randomly assigned to undergo either modified ultrasonic scalpel hemorrhoidectomy incorporating figure-eight closure ( n = 39) or Milligan–Morgan hemorrhoidectomy ( n = 39). The primary outcomes were incision healing time and time to return to normal activities. Secondary outcomes included postoperative pain, complications, anal function, and patient satisfaction. The trial was approved by the institutional ethics committee and registered in the Chinese Clinical Trial Registry (ChiCTR2100047229). The intervention group showed significantly shorter incision healing time ( P < 0.05) and faster return to normal activities. The intervention group also demonstrated lower resting pain scores at 8 h after operation and lower defecation pain scores on postoperative days 2, 5, 6, and 7 ( P < 0.05). In addition, the incidence of urinary retention and postoperative bleeding scores were lower in the intervention group than in the control group ( P < 0.05). However, no significant differences were observed in overall clinical efficacy, postoperative anal function, or patient satisfaction ( P > 0.05). Modified ultrasonic scalpel hemorrhoidectomy incorporating figure-eight closure was associated with faster wound healing and earlier recovery compared with Milligan–Morgan hemorrhoidectomy. These findings suggest that this technique may provide short-term postoperative benefits; however, further multicenter studies with larger sample sizes and longer follow-up are required to confirm its long-term efficacy and safety. Chinese Clinical Trial Registry, ChiCTR2100047229. Registered on 11 June 2021.