Objective To explore the clinical efficacy of ruiyun procedure for hemorrhoids-4(RPH-4) assisted external hemorrhoidectomy in the treatment of the elderly with severe hemorrhoids. Methods From May 2016 to July 2018

the clinical data of 82 elderly patients with severe hemorrhoids were retrospectively analyzed.They were divided into two groups according to different surgical methods

42 cases treated with RPH4 assisted external hemorrhoidectomy were as RPH-4 group

40 cases treated with traditional milliganmorgan(MM) were as MM group.The operative time

bleeding volume

hospitalization time

fine control of defecation disorder

postoperative pain (24 hours

3 days

7 days after surgery)

bleeding in outofline phase

healing time and incidence of anal edema were compared between the two groups. Results There were significant differences in operation time

bleeding volume

hospitalization time

fine control of defecation disorder

postoperative pain (24 hours

3 days

7 days after surgery)

bleeding in outofline period

healing time and incidence of anal edema between the two groups(P<0.05).After 6 months of followup

both groups achieved clinical cure

no anal function incontinence nor stenosis occurred.ConclusionUnder strict perioperative management

RPH4 assisted external hemorrhoidectomy for elderly patients with severe hemorrhoids is a safe treatment with less pain

rapid recovery and fewer postoperative complications.