Abstract: Objective This study aimed to compare the clinical efficacy of double-notch procedure for prolapse and  hemorrhoids and traditional procedure for prolapse  and hemorrhoids (PPH) in the treatment of prolapsed circular hemorrhoids combined with internal rectal prolapse.Methods From June 2023 to June 2024,80 patients diagnosed with prolapsed circular hemorrhoids accompanied by internal rectal prolapse who were admitted to our department and elected surgical intervention were randomly assigned to either a treatment group or a control group,with 40 patients in each.The treatment group underwent double-notch PPH,whereas the control group underwent conventional PPH.Outcomes assessed included overall postoperative clinical efficacy,incidence of anal stenosis,pre-and postoperative Wexner constipation scores,intraoperative blood loss,postoperative anal pain measured by the visual analogue scale (VAS),operative duration,length of hospital stay,and the occurrence of postoperative complications.Results One month after surgery,the overall clinical effective rate was marginally higher in the treatment group compared to the control group;however,this difference did not reach statistical significance.At one-year follow-up,the total effective rate was significantly higher in the treatment group than in the control group (P<0.05),and the incidence of postoperative anal stenosis was significantly lower in the treatment group (P<0.05).Although the total incidence of postoperative complications was lower in the treatment group,the difference was not statistically significant (P>0.05).No significant difference was observed in baseline Wexner constipation scores between the two groups (P>0.05).At 12 months postoperatively,the reduction in Wexner constipation scores was significantly greater in the treatment group compared to the control group (P<0.05).Conclusion In the management of patients with prolapsed circular hemorrhoids complicated by internal rectal prolapse,double-notch PPH demonstrates superior longterm clinical effectiveness and a reduced risk of anal stenosis compared to conventional PPH.Both procedures effectively alleviate constipation symptoms to some extent.Overall,doublenotch PPH exhibits more favorable long-term outcomes and holds promise for broader clinical application.

Key words: prolapsed circular hemorrhoids, double-notch PPH, internal rectal mucosal prolapse, anal stenosis