Haemorrhoidectomy according to Ferguson in day-surgery. Experience and results

Abstract

AIM OF THE STUDY: 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.

MATERIAL AND 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 criotherapy or elastic ligature, 500 patients for grade II haemorrhoids 25% of them previous treated by criotherapy 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.