Outpatient haemorrhoidectomy under local anaesthesia.

A Lacerda-Filho, J R Cunha-Melo
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Abstract

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Results: One patient was withdrawn from the study because of hypertension and subsequently lost to follow-up.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.

局部麻醉下门诊痔疮切除术。
目的:比较局麻门诊痔切除术与住院痔切除术的早期和晚期效果及费用。设计:前瞻性研究与历史对照。地点:巴西大学医院。研究对象:51例痔切除术患者。干预措施:局部麻醉下门诊痔疮切除术。主要结果测量:早期和后期结果和比较成本。结果:1例患者因高血压退出研究,随后失去随访。其余50例患者术后平均68(23)分钟出院。12例患者主诉剧痛,1例出现大便嵌塞,2例出现出血。1例患者出现尿潴留,而历史组为18例(p < 0.001)。42例患者(84%)对治疗完全满意。晚期并发症与历史组无明显差异。门诊费用估计为313.6美元,住院治疗费用估计为716美元。结论:局部麻醉下门诊痔疮切除术对大多数患者来说是安全舒适的,并发症发生率与住院治疗相当或更好,费用不到住院治疗的一半。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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