[Ambulatory anal surgery: a feasibility study]

Because of the current economic situation, ambulatory surgery has become a "modus vivendi" for the surgeon. The aim of this study is to examine the feasibility of anal ambulatory surgery and the results obtained over a period of 12 months. 141 consecutive patients underwent anal surgery: 108 on an ambulatory basis (77%) and 33 were admitted to the hospital (23%). The reasons for admitting the patients were the complexity of the operation in 19 (8 sphincteroplasty, 5 complex fistulae, 3 recto-vaginal fistulae...) emergency procedures in 9 and miscellaneous reasons in 5 patients. All 108 patients operated on an ambulatory basis could be discharged at the end of the day but two, one for urinary retention and another because he underwent a more extensive procedure than first planned. Three more had urinary retention; they were catheterized and discharged on the same day. The four patients (3 women and 1 man) developed urinary retention following spinal anesthesia. Three patients (2.7%) had to come back to the emergency room in the first 24 hours for bleeding from the operative site. One of them had to be transfused and reoperated for hemostasis. In conclusion, ambulatory anal surgery is feasible in a large proportion of cases (77%) with a low rate of complications (7.4%) and low rate of unexpected hospital admission (2.7%). In a specialized colorectal unit, 23% of patients required hospitalization for a longer stay.