Anal cushion lifting method is a novel radical management strategy for hemorrhoids that does not involve excision or cause postoperative anal complications

Table 1 Classification of internal hemorrhoids

Grade	Physical findings
I	Prominent hemorrhoidal vessels, no prolapse
II	Prolapse with Valsalva maneuver; spontaneous reduction
III	Prolapse with Valsalva maneuver; requires manual reduction
IV	Chronically prolapsed; manual reduction ineffective

Table 2 Clinical characteristics and outcomes of patients that underwent the anal cushion method (n = 127)

Characteristics and outcomes	Values (95%CI)
Age (yr)	42 (19-84)
Gender (male:female)	32 (25.2%): 95 (74.8%)
Grade (2:3:4)	1 (0.8%): 113 (89.0%): 13 (10.2%)
Follow-up time (mo)	26 (0-88)
Operative time (min)	15 (4-30)
Duration of analgesic treatment (d)	3 (2-13)
No. of intravenous analgesic injections	0 (0-9)
No. of doses of extra-oral analgesic medication administered	3 (0-21)
Duration of hospital stay (d) (Time to resumption of normal activity)	7 (2-13)
Total complications	10/127 (7.9%)
Bleeding	1 (0.8%)
Urinary retention	6 (4.7%)
Recurrence	3 (2.4%)
Anal stenosis	0
Infection	0
Persistent anal pain during hospital stay	0

Table 3 Perioperative and postoperative findings of conventional hemorrhoidectomy methods

Ref.	Bikhchandani et al[15]	Shalaby et al[10]	Bulus et al[16]	Correa-Rovelo et al[9]
Method	MM	MM	Ferguson	Ferguson
No. of patients	42	100	71	42
Operative time (min) (mean ± SD)	45.2 ± 5.4	19.7 ± 4.7	25.5 ± 7.7	38.1 ± 12.9
Complications (%)
Bleeding	2.4	2.0	4.2	0
External tags	2.4	1.0	-	4.9
Anal stenosis	0	5.0	1.4	2.4
Infection	0	-	1.4	-
Urinary retention	16.7	14.0	28.2	7.1
Recurrence	5.0	2.0	8.5	0

MM: Milligan-Morgan.