Objective To investigate the clinical effect of external hemorrhoidectomy combined with graded ligation-sclerotherapy for internal hemorrhoids in mixed hemorrhoids. Methods A retrospective analysis was conducted on the clinical data of 247 patients with mixed hemorrhoids. The patients were assigned to an observation group (n=123) and a control group (n=124) based on different surgical procedures. The observation group was treated with external hemorrhoidectomy combined with graded ligation-sclerotherapy for internal hemorrhoids, while the control group received external dissection and internal ligation. The operation duration, intraoperative blood loss, wound healing time, time to first defecation, and postoperative hospital stay were compared between the two groups, together with visual analogue scale (VAS) scores at 24 hours postoperatively and during the first defecation, the incidence of complications, and the recurrence rate. Results The observation group exhibited shorter operation duration, less intraoperative blood loss, shorter wound healing time, shorter time to first defecation, and shorter postoperative hospital stay (P<0.05), lower VAS scores at 24 hours postoperatively and during the first defecation (P<0.05), a lower total complication rate (χ²=7.729, P=0.005), and a lower recurrence rate (χ²=6.347, P=0.012) than the control group. Conclusion External hemorrhoidectomy combined with graded ligation-sclerotherapy for internal hemorrhoids in the treatment of mixed hemorrhoids can shorten operation duration, reduce intraoperative blood loss, accelerate wound healing and relieve postoperative pain. It is a safe, effective and minimally invasive treatment strategy with high value for clinical promotion and application.

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