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Outpatient haemorrhoidectomy under local anaesthesia
A Lacerda-Filho1, J R Cunha-Melo
1Department of Surgery, School of Medicine, University Hospital, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Objective:
To compare early and late results and costs of outpatient haemorrhoidectomy under local anaesthesia with those of inpatient haemorrhoidectomy.
Design:
Prospective study with historical controls.
Setting:
University hospital, Brazil.
Subjects:
51 patients who required haemorrhoidectomy.
Interventions:
Outpatient haemorrhoidectomy under local anaesthesia.
Main Outcome Measures:
Early and late results and comparative costs.
Results:
One patient was withdrawn from the study because of hypertension and subsequently lost to follow-up. The remaining 50 patients were discharged a mean of 68 (23) minutes after operation. Twelve patients complained of severe pain, one had faecal impaction and 2 developed bleeding. One patient developed urinary retention, compared with 18 in the historical group (p < 0.001). Forty-two patients (84%) were thoroughly satisfied with their treatment. Late complications did not differ significantly from those observed in the historical group. The estimated hospital costs were US$ 313.6 for outpatient, and US$ 716 for inpatient treatment.
Conclusion:
Outpatient haemorrhoidectomy under local anaesthesia was safe and comfortable for most patients, with complication rates comparable to or better than those observed after inpatient treatment and at less than half the cost.