Day-case haemorrhoidectomy.
BACKGROUND
Ligation excision haemorrhoidectomy is usually performed on an inpatient basis. This study was designed to assess the feasibility of day-case haemorrhoidectomy.


METHODS
Patients fulfilling criteria for day surgery underwent ligation excision haemorrhoidectomy with the intention of a same-day discharge from hospital. A standardized protocol for anaesthesia, perioperative analgesia and antiemesis was followed. Patients received daily home nursing visits until they felt both comfortable and confident. Staff recorded pain and nausea scores on a visual analogue scale (range 1-10) until the first bowel action. Patient satisfaction was assessed independently after operation.


RESULTS
Fifty-one patients underwent planned day-case haemorrhoidectomy. Forty-two (82 per cent) were discharged on the day of surgery. All patients were discharged within 26 h of surgery. Four patients required readmission, two with reactive bleeding, one with urinary retention and one for pain control. Pain and nausea were well controlled. Forty-four patients (86 per cent) were totally or very satisfied with their overall care.


CONCLUSIONS
Ligation excision haemorrhoidectomy can be performed successfully as a day-case procedure.
Hunt
L
L
Department of Surgery, Leicester Royal Infirmary NHS Trust, UK.
Luck
A J
AJ
Rudkin
G
G
Hewett
P J
PJ
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000379:methods
D000700:Analgesics