Abstract: Stapled anoplasty for haemorrhoids: a comparison of ambulatory vs. in-patient procedures.

Authors:

Guy RJ, Ng CE, Eu KW.

Institution:

Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608.

Source:

Colorectal Dis. 2003 Jan;5(1):29-32.

Abstract:

OBJECTIVE: Haemorrhoids are commonly seen in colorectal practice. Stapled anoplasty is a novel approach to the treatment of this condition and is usually performed as an in-patient procedure. The aim of this study was to investigate the suitability of this technique for ambulatory surgery. PATIENTS AND METHODS: Fifty consecutive patients undergoing stapled anoplasty under general anaesthesia as day cases (DC) (mean age 41 years; 27 females) by a single consultant surgeon over a 12-month period were compared with 50 consecutive patients undergoing the same procedure as in-patients (mean age 44 years; 25 females) (IP) during the same period. RESULTS: Eight DC patients (16%) were admitted overnight from the day surgery unit for urinary retention (3), pain (2), bleeding (2) and anaesthetic reasons (1). Three other DC patients were re-admitted after a mean period of 4 days with bleeding (2), one of which required surgical haemostasis, and a septic complication (1). Mean hospital stay for IP cases was 2.6 (range 1-9) days. Two IP cases were re-admitted after 4 and 11 days for bleeding and wound infection, respectively. At review 2-4 weeks after discharge, satisfaction in both groups was high. Minor staple-line strictures were seen in 1 DC and 2 IP cases but all were easily dilated digitally. Mean costs incurred were significantly less for day surgery patients. CONCLUSIONS: Stapled anoplasty is suitable for use in day-case surgery as it is a quick and relatively painless procedure. The advantages, particularly financial, support the technique for use in an ambulatory setting, preferably in the morning, and provided detailed patient advice is given.

Keywords:

General Surgery Haemorrhoidectomy Stapled Anoplasty