To assess the safe anastomotic distance of TST technique for circumferential hemorrhoids and analyze its clinical effect.

120 patients with circumferential hemorrhoids all were treated by TST technique. These patients were divided into four groups according to the position of anastomotic stoma, the distance from the anastomotic stoma to dentate line was 1.0-1.5 cm, 1.5-2.0 cm, 2.0-2.5 cm, 2.5-3.0 cm, respectively (group 1, 2, 3, 4), 30 cases in each group. After that, during the launching process of TST, the condition of hypogastralgia, radiating pain of perineum, and osphyalgia were observed by intraoperative subjective assessment; during the early postoperative period, the condition of pain score, edema score, bulge score, urinary score, and defecation score were observed by postoperative initial assessment; the condition of copracrasia, anastomotic stenosis, and rectal mucosal prolapse were observed by postoperative mid-late assessment combined with rectoanal manometry and dynamic defecography, and meanwhile the clinical effects and satisfaction of the patients were investigated.

TST technique was performed successfully among all patients. But in the group 1, a patient underwent the second operation because of anastomotic bleeding. According to the intraoperative subjective assessment, during the launching process of TST, the incidences of hypogastralgia, radiating pain of perineum, and osphyalgia in the group 2, 3, 4 were significantly lower than those in the group 1 (all P<0.05). According to the postoperative initial assessment, the pain score, edema score, bulge score, urinary score, and defecation score in the group 2 were obviously better than those in the group 1, 3, 4 (allP<0.05). According to the postoperative mid-late assessment, the copracrasia, anastomotic stenosis, and rectal mucosal prolapse in the group 2 were obviously better than those in the group 1, 3, 4 (allP<0.05). The clinical effect and satisfaction in the group 2 were the best, followed by the group 3 (allP<0.05).

The optimum safe distance of anastomotic stoma is 1.5-2.0 cm from the anastomotic stoma to dentate line. Therefore this TST technique deserves to be applied in clinic because of its operational safety and feasibility, as well as its remarkable effects.

Circumferential hemorrhoids; TST technique; Safe anastomotic distance; Clinical effect