ADVANCED STRATEGIES IN MANAGING COMBINED CHRONIC HEMORRHOIDS AND ANAL FISSURES

This article presents a comparative study evaluating the surgical outcomes in patients with stage III–IV chronic hemorrhoids combined with chronic anal fissure. The effectiveness of a minimally invasive approach—transanal hemorrhoidal dearterialization (THD) combined with fissure excision—was compared to conventional Milligan–Morgan hemorrhoidectomy with fissure removal. The results showed that the THD-based method significantly reduced postoperative pain, accelerated wound healing, and lowered the rate of complications and recurrences, suggesting that it is a preferable surgical strategy in the management of this combined anorectal pathology.