title: Stapled hemorrhoidopexy as a day-surgery procedure.
abstract: In the last 10 years, stapled hemorrhoidectomy has gained worldwide consensus. We studied a day-surgery stapled hemorrhoidopexy protocol to allow shorter recovery time and cost reduction. From 2003 to 2008, we performed 292 outpatient stapled hemorrhoidopexies under spinal or local anesthesia including symptomatic Grade III and IV hemorrhoid disease. We used PPH 01 to PPH 03 staplers. We assessed early and late postoperative pain with a Visual Analog Scale, whereas clinical postoperative examinations were performed at seven days, 6 months, and 1, 3, and 5 years after surgery. The mean surgery time was approximately 18 minutes (range, 13 to 39 minutes). Of 292 patients, 39 were not dischargeable for urine retention, severe pain, or mild bleeding. Four other patients were rehospitalized within 8 days for bleeding. Twenty-one patients reported transient fecal urgency, whereas nobody reported anal incontinence. We can conclude that stapled hemorrhoidopexy is a safe and effective procedure if performed in a day-surgery unit. The complication rate is comparable to that of inpatient procedures.
authors.affiliation: Department of General Surgery, Day Surgery Unit, Ospedale Sant’Andrea, Rome, Italy. umilemichele.cosenza@fastwebnet.it
authors.forename: Umile M
authors.initials: UM
authors.lastname: Cosenza
authors.forename: Luigi
authors.initials: L
authors.lastname: Masoni
authors.forename: Stefano
authors.initials: S
authors.lastname: Conte
authors.forename: Mauro
authors.initials: M
authors.lastname: Simone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nigri
authors.forename: Francesco S
authors.initials: FS
authors.lastname: Mari
authors.forename: Andrea
authors.initials: A
authors.lastname: Milillo
authors.forename: Antonio
authors.initials: A
authors.lastname: Brescia
mesh_terms: D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome