Randomized controlled trial comparing same-day discharge with hospital stay following haemorrhoidectomy.
BACKGROUND
A randomized controlled trial was conducted to compare traditional hospital stay haemorrhoidectomy (STAY) with same-day discharge haemorrhoidectomy (DAY) with regard to costs, clinical outcome and patient satisfaction.


METHODS
A total of 54 consecutive patients were randomized to either STAY or DAY groups. A standardized excision of three piles was performed and the wounds were left open. The DAY patients went home on the same day but the STAY patients remained in hospital until their bowels had opened. A linear analogue pain score and patient satisfaction questionnaire were administered. During a mean follow-up of 60.5 (standard error of mean = 1.2) weeks, the complications and the total medical costs were recorded


RESULTS
There were no differences in the age and sex distributions in both groups (STAY: 11 men, 16 women; mean age 40.6 (+/- 1.8) years; DAY: 10 men, 17 women; mean age 40.6 (+/- 1.9) years). Despite accounting for any readmissions, the DAY patients accumulated shorter total hospitalization stays (P < 0.001) and incurred less total medical costs (P = 0.04). The pain scores, analgesia requirements, postoperative complications, patient satisfaction and time taken off work were not different between the two groups. However, more patients in both groups preferred to stay after surgery if they should need another haemorrhoidectomy.


CONCLUSIONS
Haemorrhoidectomy (with excision of three piles) can be safely performed as a day procedure, with reduced hospitalization and medical costs.
Ho
Y H
YH
Department of Colorectal Surgery, Singapore General Hospital. HoYH@sgh.gov.sg
Lee
J
J
Salleh
I
I
Leong
A
A
Eu
K W
KW
Seow-Choen
F
F
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000191:economics; D000768:Anesthesia, General; D003365:Costs and Cost Analysis; D005260:Female; D006484:Hemorrhoids / Q000191:economics / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D010351:Patient Discharge; D017060:Patient Satisfaction