[Haemorrhoidectomy according to Ferguson in day-surgery. Experience and results].
OBJECTIVE
To evaluate of results of 1511 surgical haemorrhoidectomies performed in day-surgery setting (7-24 hours hospital stay) with improvement of both cost effectiveness and patient comfort.


METHODS
From January 1980 to December 2002, 1511 patients underwent haemorrhoidectomy according to Ferguson, 1011 patients for grade III-IV haemorrhoids 10% of them for recurrence and 5% previous treated by cryotherapy or elastic ligature, 500 patients for grade II haemorrhoids 25% of them previous treated by cryotherapy or elastic ligature and 7% for recurrence. 97.6% of patients were operated on with loco-regional anaesthesia; the others with narcosis and peripheral anaesthesia. The hospital-stay was 24 hours in 34% of patients, while the remaining 66% operated on under loco-regional anaesthesia were hospitalised for 7-10 hours. Twenty-seven patients (1.8%) have had postoperative haemorrhage, only three patients (0.2%) underwent reoperation under general anaesthesia with a hospital stay of 7 days. In 52% of patients clinical recovery was observed at first follow-up (7 days); 48% had recovered at the second follow-up (14 days).


RESULTS
In 1286 patients (98% of patients came back to control) anatomical recovery was observed at the follow-up three months after surgery. Patients satisfaction 6 months after operation was high in 73%; good in 26%; low in 1%.


CONCLUSIONS
These results seems confirm the feasibility of haemorrhoidectomy in day-surgery in almost all patients, with both a considerably cost reduction and enhanced patient comfort and compliance.
Carditello
Antonio
A
Dipartimento di Discipline Chirurgiche Generali e Speciali, Università degli Studi di Messina.
Stilo
Francesco
F
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012008:Recurrence; D012086:Reoperation; D012720:Severity of Illness Index; D016896:Treatment Outcome