Evaluation of Mucopexy-Recto Anal Lifting (MuRAL): A New Method for Treating Hemorrhoids.

Abstract

Objectives: Ligation and excision remain the commonly recognized standard surgical modality for treating hemorrhoids. Further, impediments to surgical treatment owing to social factors and the need for minimally invasive procedures and other confounders have resulted in the adoption of the mucopexy-recto anal lifting (MuRAL) method which is associated with favorable outcomes. The objective of this study was to describe the procedure and report the outcomes in patients who underwent MuRAL. Methods: Between March 2016 and February 2018, 55 patients (26 males and 29 females) underwent MuRAL for hemorrhoids and rectal mucosal prolapse. The duration of the surgical procedure and hospitalization, postoperative complications, and satisfaction were evaluated. Results: The mean age of the male patients (n = 26) was 61.5 ± 4.9 years and that of the female patients (n = 29) was 61.5 ± 3.2 years. The mean duration of surgery was 46 ± 23 minutes for males and 53 ± 28 minutes for females, and the mean observation duration was 317 ± 186 days. Intraoperative hemorrhage was low for males and females. The mean hospitalization period was 3.2 ± 1.5 days for males and 4.3 ± 2.1 days for females. Differences in several postoperative complications were observed between male and female patients. Postoperative satisfaction was rated high by the patients. Conclusions: Risks of hemorrhage and pain associated with the MuRAL method were low because the procedure does not involve incision or excision. Other than ligation and excision, recurrence is favorable compared with that of other surgical modalities for the treatment of hemorrhoids.