Effects of multiple mesh-pattern incisions combined with sclerotherapy for internal hemorrhoids on postoperative anal appearance and functional recovery in patients with mixed hemorrhoids

Abstract Objective To evaluate the efficacy, safety, and prognostic outcomes of multiple small incisions in hemorrhoidal tissue combined with sclerotherapy for internal hemorrhoids in restoring anal appearance and function after surgery for grade III–IV mixed hemorrhoids. Methods A total of 300 patients with circumferential mixed hemorrhoids who met the inclusion criteria and underwent surgery in the Department of Colorectal Surgery at Xuchang Central Hospital between July and December 2025 were randomly assigned to three groups. Group A underwent multiple small incisions arranged in a mesh pattern combined with sclerotherapy for internal hemorrhoids. Group B underwent conventional surgery combined with Xiaozhiling injection for internal hemorrhoids. Group C underwent conventional external hemorrhoidal excision and internal hemorrhoidal ligation. Postoperative outcomes were recorded, and patients were followed for 6 months to assess long-term recovery of anal function. Results The rates of wound edema, urinary retention, wound bleeding, and anal stenosis at 6 days after surgery were 6%, 9%, 7%, and 6%, respectively, in group A, significantly lower than those in group B (19%, 21%, 18%, and 11%) and group C (24%, 25%, 25%, and 21%). Intraoperative blood loss did not differ significantly among the three groups. Overall, group A had better outcomes in terms of postoperative complications, pain relief, wound healing, anal function, and quality of life, as well as lower total hospitalization costs. The incidence of anal stenosis did not differ significantly between groups A and B. Group B showed a more pronounced postoperative inflammatory response, although its complication rates did not differ significantly from those in group C. Recovery was generally slower in group C, which had the highest rates of postoperative bleeding and anal stenosis. Conclusion In patients with severe mixed hemorrhoids, multiple small incisions arranged in a mesh pattern combined with sclerotherapy for internal hemorrhoids provide better therapeutic outcomes and recovery of anal function than conventional external excision and internal ligation.