SHAPE-skin-sparing hemorrhoidectomy and PExy: a novel technique for the surgical treatment of hemorrhoidal disease.

Hemorrhoidal disease (HD) is a prevalent condition that often requires surgical intervention in advanced stages. This study evaluates the short-term outcomes of Skin-Sparing Hemorrhoidectomy and Pexy (SHAPE), a novel hybrid technique that integrates the excisional approach of closed hemorrhoidectomy with the tissue-sparing and fixation benefits of suture ligation with mucopexy. SHAPE selectively excises the internal hemorrhoidal column while preserving the anoderm and incorporates mucopexy to reposition prolapsed tissue, potentially reducing both recurrence and morbidity. A prospective analysis was conducted on 21 consecutive patients with grade III-IV HD who underwent SHAPE on 3 hemorrhoidal columns. At 1-month follow-up, patients experienced a significant reduction in symptoms, with the Hemorrhoidal Disease Severity Score (HDSS) decreasing from a median of 16 to 0 (p < 0.001) and the Short Health Scale (SHS) from 20 to 4 (p < 0.001). The median operative time was 22 min, and hospital stay was typically 1 day. Complications occurred in five patients (four cases of urinary retention, one bleeding requiring revision). No persistent pain was reported. SHAPE appears to be a promising alternative that combines the advantages of excisional and tissue-sparing techniques. Further studies are needed to assess its long-term efficacy and recurrence rates.