Day case stapled haemorrhoidopexy for prolapsing haemorrhoids
| Autor: | Malcolm A. Loudon, G. C. Beattie, Stuart McIntosh, T. K. McAdam |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Postoperative pain medicine.medical_treatment Fourth degree Asymptomatic Rubber band ligation Hemorrhoids law.invention Surgical Staplers Randomized controlled trial law Outpatients medicine Restricted activity Humans Retrospective Studies Urinary retention business.industry Suture Techniques Gastroenterology Middle Aged Surgery Clinical trial Treatment Outcome Ambulatory Surgical Procedures Female medicine.symptom business Vascular Surgical Procedures Follow-Up Studies |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland. 8(1) |
| ISSN: | 1462-8910 |
| Popis: | Objective Conventional surgical management of prolapsing haemorrhoids is by excisional haemorrhoidectomy. Postoperative pain has restricted the application of such procedures in the day case setting. These operations remain associated with a period of restricted activity. The use of circular stapling devices as an alternative to the excisional approach in the management of haemorrhoids has been described. This study reports our experience of stapled haemorrhoidopexy as a day case procedure. Methods Patients with third or fourth degree haemorrhoids were eligible for the procedure. Patients were considered suitable candidates for day case surgery based on conventional parameters. Symptoms were assessed using a previously validated symptom severity rating score. Stapled haemorrhoidopexy was carried out using a circular stapling device. Pain scores were obtained prior to discharge. Patients were admitted if pain was uncontrolled despite oral analgesia. Symptoms were re-scored at six-week follow-up. Results Over a 70-month period 168 consecutive stapled haemorrhoidopexies were performed or directly supervised by one consultant colorectal surgeon. One hundred and ten (65%) patients were considered appropriate candidates for day case surgery by conventional criteria. Ninety-six (87.3%) patients successfully underwent stapled haemorrhoidopexy on a day case basis. Fourteen (12.7%) patients required admission on the day of surgery (5 for early postoperative bleeding, 4 for pain necessitating continuing opiate analgesia, two for urinary retention and three for surgery performed late in the day). Six (5%) patients were re-admitted postoperatively; four for pain relief and two because of urinary retention. Of the day case patients, 91 (82.7%) and 56 (50.9%) had been seen for 6 week and 6 month review, respectively, at the time of analysis. Symptom scores were 6 (pre-operatively) vs 0 (postoperatively) (P |
| Databáze: | OpenAIRE |
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