This observational multicenter study aims to develop and validate the Hemorrhoidectomy Quality Assessment Scale (HeQAS), a histopathological tool designed to assess the technical quality of excisional hemorrhoidectomy. The project includes a methodological validation phase using blinded assessment of surgical specimens by expert pathologists, followed by a clinical cohort phase comparing micro-open excisional hemorrhoidectomy (microOEH) and conventional open excisional hemorrhoidectomy (OEH) in real-world practice. The study will evaluate the reproducibility and applicability of HeQAS and explore whether microOEH is associated with lower histological tissue damage than conventional OEH.
Inclusion Criteria:
Availability of the surgical specimen with adequate histopathological preservation for standardized processing and HeQAS assessment.
Availability of routine clinical follow-up data required for outcome assessment (pain, complications, and 12-month clinical status).
Exclusion Criteria:
Surgical specimens with inadequate fixation, autolysis, or fragmentation that preclude reliable histopathological assessment according to the protocol.
Incidental diagnosis of malignancy (carcinoma) in the surgical specimen.
Intraoperative change of surgical technique that prevents clear assignment to one cohort (micro-open excisional hemorrhoidectomy or conventional open excisional hemorrhoidectomy).
Prior use of the same specimen in the methodological validation study (Study 1) of HeQAS.
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Patients undergoing micro-open excisional hemorrhoidectomy in routine clinical practice.
Patients undergoing conventional open excisional hemorrhoidectomy in routine clinical practice.
Palma de Mallorca, Balearic Islands 07190, Spain
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