TPT 7.06 Clinical Outcomes of Vikas’s Modification of Chivate’s Non-Excisional Procedure for Grade II–IV Hemorrhoids: A Multicenter Retrospective Study
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2026
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Abstract
Abstract Background Chivate’s non-excisional procedure is widely used for the management of Grade II–IV hemorrhoids; however, postoperative bleeding, mucosal edema, pain, and recurrence remain clinically relevant limitations. Vikas’s Modification was developed to optimize patient positioning and suturing technique to improve postoperative and functional outcomes. We compare clinical outcomes of the original Chivate procedure with Vikas’s Modification in patients with advanced hemorrhoidal disease. Methods A retrospective comparative analysis was conducted including 2,535 patients, of whom 1,850 underwent the Chivate procedure and 685 were treated with Vikas’s Modification. The modified technique incorporated steep head-low positioning, gentle graded anal dilatation, and a standardized tenting suturing method with controlled stitch length and depth. Outcomes assessed included postoperative bleeding, mucosal edema, pain, and recurrence. Relative risks (RR) with 95% confidence intervals (CI) were calculated. Between-group comparisons were performed using Fisher’s exact test. Absolute risk reduction (ARR), relative risk reduction (RRR), and number needed to treat (NNT) were derived from observed event rates. Results Vikas’s Modification significantly reduced postoperative bleeding (1.24% vs 0.29%; RR 0.23, 95% CI 0.06–0.99; p<0.05; NNT=106), mucosal edema (5.95% vs 1.02%; RR 0.17, 95% CI 0.08–0.37; p<0.001; NNT=21), and postoperative pain (4.54% vs 1.31%; RR 0.29, 95% CI 0.15–0.57; p<0.001; NNT=31). Recurrence rates were numerically lower (0.59% vs 0.44%; RR 0.74, 95% CI 0.21–2.63; p>0.05; NNT=667). Conclusions Vikas’s Modification provides statistically and clinically useful reductions in postoperative morbidity while maintaining low recurrence rates, representing a safe, reproducible, and function-preserving refinement of non-excisional surgery for advanced hemorrhoids.
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| Authors | Vikas Jain, Prashant Rahate, Jiten Chowdhry, Kanhaiya Chandak, Riya Jain, Rishabh Jain |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.246
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| URL | |
| Keywords | Keywords not found |
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