Day case haemorrhoidectomy in a developing country

Ligation excision haemorrhoidectomies are usually done on inpatient basis. Over the years however, there has been an increase in the numbers done on outpatient basis. This retrospective review was conducted to evaluate the results of day case haemorrhoidectomy in a developing country.

Forty three consecutive patients, who met the criteria for day case surgery, had ligation excision haemorrhoidectomy, between January 2004 and September 2005 at the Royal Victoria Teaching Hospital (RVTH) Banjul with the intention of same-day discharge from hospital. For each patient, data collected included age, sex, duration of symptoms, degree of haemorrhoids, and duration of rest after the procedure in minutes or hours, whether the patient was discharged same day or needed admission for complications. Local anaesthesia, 1% lignocaine was used for all the patients.

Forty three patients comprising 28 males (65.1%) and 15 females (34.9%), with a male female ratio of 1.87:1 underwent planned day case haemorrhoidectomy. Their mean age was 36.27 +/- 10.26 years and range was 25 to 56 years. Forty patients (93%) were discharged on the same day of surgery after a rest period in the day care theatre ranging between 25 minutes and 60 minutes with a mean of 41.2 +/- 11.08 minutes. Three (7%) of the patients required admission, two for acute urinary retention and control of excessive pain and the other 5 days postoperative on account of secondary haemorrhage. Pain control was achieved by oral non steroidal antiinflammatory agents. There were no deaths and majority of the patients were satisfied with the procedure.

Ligation excision (Milligan-Morgan) haemorrhoidectomy is safe and can be performed successfully on out patient basis, saving inpatient health care costs. This is suitable for developing country.