Early experience of stapled hemorrhoidectomy in a community hospital setting.
BACKGROUND
Stapled hemorrhoidectomy was introduced as a new procedure for the surgical management of hemorrhoidal disease in 1993. We present a cohort longitudinal study performed in a community hospital setting where the short-term outcomes of stapled hemorrhoidectomy were compared with those of conventional hemorrhoidectomy.


METHODS
We compared 41 consecutive patients who underwent a conventional open diathermy (Ferguson) hemorrhoidectomy between September 1999 and September 2001 with 40 consecutive patients who underwent a stapled hemorrhoidectomy procedure between September 2001 and June 2004. We analyzed perioperative and postoperative complications, length of hospital stay, patient satisfaction and case costing for both groups.


RESULTS
The stapled hemorrhoidectomy group comprised 13 men and 27 women. The open hemorrhoidectomy group comprised 9 men and 32 women. There were no intraoperative complications in either group. In the stapled hemorrhoidectomy group, 3 patients presented with postoperative complications and 3 required admission. In the open hemorrhoidectomy group, 14 patients presented with postoperative complications and 11 required admission. At 2-week follow-up, 35 patients (88%) presented no complaints in the stapled hemorrhoidectomy group, versus 27 (66%) in the open hemorrhoidectomy group. The total cost calculated for the stapled hemorrhoidectomy procedure was dollar 716.38, whereas the total cost of the open hemorrhoidectomy procedure was dollar 760.00.


CONCLUSIONS
The stapled hemorrhoidectomy technique is a safe alternative to the traditional open hemorrhoidectomy. It can be performed as an outpatient procedure, is well tolerated by patients and is no more expensive than conventional surgical therapy.
Touzin
Eric
E
Division of General Surgery, Department of Surgery, University of Ottawa, Ottawa.
Hegge
Susan
S
McKinley
Craig
C
D000328:Adult; D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D013536:Suture Techniques / Q000191:economics / Q000295:instrumentation*; D016896:Treatment Outcome