Socioeconomic aspects of day case surgery for hemorrhoids
Journal Title: Lietuvos Chirurgija - Year 2006, Vol 4, Issue 3
Abstract
Objective This study explores the patients’ attitude towards the day case surgery of haemorrhoids. Patients and methods Patients operated on in 2003 because of hemorrhoids were questioned by mail (a retrospective study). All the patients had been suffering from stage III–IV haemorrhoids. Anesthesia of the perianal block with intravenous sedation and the Milligan–Morgan haemorrhoidectomy were applied. COX-2 inhibitors were used for pain prevention and postoperative analgesia. Results The anus problems before the operation in 94.1% of the respondents impeded their social activities and work. 91.2% of the patients after the operation had no complaints they suffered before the operation. 21 (62%) respondents experienced no problems at all. The perineal block analgesia was evaluated as excellent by 13 (38.2%) patients, as very good by 11 (32.4%), as good by 6 (17.6%), as not bad by 4 (11.8%). Postoperative analgesia was evaluated as excellent by 6 (17.6%) patients, as very good by 12 (35.3%), as good by 11 (32.4%), as not bad by 5 (14.7%). One-day hospital stay was evaluated as sufficient by 28 (82.4%) patients, and 6 (17.6%) patients considered that the in-hospital stay too short. Sixteen patients were treated by the operating surgeon (47%), by a clinic surgeon (7–20.5%), by family doctor (4– 12%), 7–20.5% recovered on their own guided by the operating surgeon instructions. The anus healing lasted (according to the patients) from 2 to 12 weeks. The patients went back to work not equally quickly. Six (17.6%) needed 1 week, 5 (14.7%) 2 weeks, 6 (17.6%) 3 weeks, 6 (17.6%) 4 weeks, 3 (9%) 6 weeks to recover. Eight patients (23.5%) were unemployed or retired. Conclusions One-day hospital stay was evaluated as sufficient by 28 (82.4%) patients. The perineal block analgesia during the operation was evaluated positively by all the patients. None of the patients noted the postoperative analgesia with the COX-2-specific inhibitor as insufficient. Long-term observation by the operating surgeon improves the socioeconomic results.
Authors and Affiliations
Paulius Žeromskas, Audrius Janėnas, Kęstutis Strupas
Keywords
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