Comparison between day surgery and non-day surgery in the procedure for prolapse and hemorrhoids (grades III-IV) with MRI-assisted diagnosis: a retrospective cohort study.

Background: To evaluate the clinical value of day surgery with MRI-assisted diagnosis for the procedure for prolapse and hemorrhoids (PPH) through a retrospective cohort study. MRI was included in the preoperative protocol for surgical planning.

Methods: A total of 107 patients who underwent day surgery PPH with preoperative perianal magnetic resonance imaging (MRI) for mixed hemorrhoids from October 2021 to July 2023 and 234 patients who underwent non-day surgery from April 2008 to April 2023 were included in this retrospective analysis. Outcomes of the two groups were compared, including intraoperative blood loss, post-discharge pain scale, time to resume normal activities, postoperative complications, healing of the anastomosis and wounds, discharge satisfaction rate, and short-term recurrence rate.

Results: The day surgery group experienced significantly less intraoperative blood loss compared to the non-day surgery group [10 (5-20) ml vs. 20 (20-50) ml, < 0.01]. The post-discharge pain scale was slightly higher in the day surgery group ( = 0.041). The discharge satisfaction rate was higher in the day surgery group (97.2% vs. 90.6%, = 0.030). Patients in the day surgery group resumed normal activities earlier than those in the non-day surgery group [20 (14-30) days vs. 30 (14-30) days, = 0.003]. The rate of postoperative residual tissue prolapse was lower in the day surgery group (0.9% vs. 6.0%, = 0.035). No significant differences were observed between the groups in terms of anastomosis and wound healing, short-term recurrence rates, or other postoperative complications (all > 0.05).

Conclusion: Day surgery with MRI-assisted diagnosis for mixed hemorrhoids is effective, feasible, and associated with shorter hospitalization times, higher patient satisfaction, faster recovery, improved resource efficiency, and enhanced bed turnover. It is a promising model worthy of clinical adoption.