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Peter Labas, Bernard Ohradka, Marek Cambal, Juraj Olejnik, Juraj Fillo, Haemorrhoidectomy in outpatient practice, European Journal of Surgery, Volume 168, Issue 11, November 2002, Pages 619–620, https://doi.org/10.1002/ejs.6161681109
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Abstract
Objective: To evaluate our results of haemorrhoidectomy done as an outpatient procedure.
Design: Retrospective study.
Setting: University hospital Bratislava, Slovak Republic.
Subject: 256 patients who required haemorrhoidectomy in 1996–2001.
Interventions: Milligan-Morgan haemorrhoidectomy under local (0.5% lignocaine with adrenaline 1:200000, 100 ml) or epidural (0.5 bupivacaine, marcain, 20 ml; or 1% lignocaine, 20 ml).
Main outcome measures: Mortality, morbidity, need for admission to hospital, and acceptability to patients.
Results: No patient died. All patients were observed in the recovery room for 0.5–8 hours (mean 5 hours). 23 of the 256 patients (9%) developed minor complications including bleeding (n = 6), pain (n = 15), anal discharge (n = 1), and retention of urine (n = 1). 5 patients (2%) were admitted for pain or retention of urine. During the first 3 days after operation 29 patients required increased analgesia for discomfort. 223 patients (87%) were satisfied with outpatient treatment, while the remaining would have preferred to be admitted to hospital.
Conclusion: Day case haemorrhoidectomy is a safe and effective way of reducing costs without increasing morbidity, mortality, and is acceptable to most patients.
