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Early experience of stapled hemorrhoidectomy in a community hospital setting
Eric Touzin1, Susan Hegge, Craig McKinley
1Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa.
Background:
Stapled hemorrhoidectomy was introduced as a new procedure for the surgical management of hemorrhoidal disease in 1993. We present a cohort longitudinal study performed in a community hospital setting where the short-term outcomes of stapled hemorrhoidectomy were compared with those of conventional hemorrhoidectomy.
Methods:
We compared 41 consecutive patients who underwent a conventional open diathermy (Ferguson) hemorrhoidectomy between September 1999 and September 2001 with 40 consecutive patients who underwent a stapled hemorrhoidectomy procedure between September 2001 and June 2004. We analyzed perioperative and postoperative complications, length of hospital stay, patient satisfaction and case costing for both groups.
Results:
The stapled hemorrhoidectomy group comprised 13 men and 27 women. The open hemorrhoidectomy group comprised 9 men and 32 women. There were no intraoperative complications in either group. In the stapled hemorrhoidectomy group, 3 patients presented with postoperative complications and 3 required admission. In the open hemorrhoidectomy group, 14 patients presented with postoperative complications and 11 required admission. At 2-week follow-up, 35 patients (88%) presented no complaints in the stapled hemorrhoidectomy group, versus 27 (66%) in the open hemorrhoidectomy group. The total cost calculated for the stapled hemorrhoidectomy procedure was dollar 716.38, whereas the total cost of the open hemorrhoidectomy procedure was dollar 760.00.
Conclusions:
The stapled hemorrhoidectomy technique is a safe alternative to the traditional open hemorrhoidectomy. It can be performed as an outpatient procedure, is well tolerated by patients and is no more expensive than conventional surgical therapy.
