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Day case versus inpatient stay for excisional haemorrhoidectomy
Author(s) -
Xia Weisi,
Barazanchi Ahmed W. H.,
MacFater Wiremu,
Sammour Tarik,
Hill Andrew G.
Publication year - 2018
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.14838
Subject(s) - medicine , demographics , hospital readmission , retrospective cohort study , urinary retention , continuous variable , cohort , exact test , diagnosis code , emergency medicine , surgery , population , demography , sociology , environmental health
Background Excisional haemorrhoidectomy has traditionally been performed on an inpatient basis due to concerns over post‐operative pain and urinary retention. Day case procedures are increasingly common. This study aims to investigate readmission rates following day case compared with inpatient haemorrhoidectomy. Methods A retrospective cohort review of all haemorrhoidectomies performed at Counties Manukau District Health Board, Auckland from January 2012 to December 2017 was queried from the hospital database. Readmission rates, reason for readmission, time to represent and length of stay within 30 days were recorded. Continuous data were analysed using Mann–Whitney U and Student's t ‐tests. Categorical data were analysed using the Fisher's exact and chi‐squared tests. Results A total of 485 cases of excisional haemorrhoidectomy were performed, with 62 (12.8%) readmissions within 30 days. There were 170 patients who were treated as day cases with 19 (11.2%) readmissions; 315 patients stayed one night or longer with 43 (13.7%) readmissions ( P = 0.97). The demographics of both groups were similar. Pain and bleeding were the most common reasons for readmission in both groups. There were no significant differences between rates of readmission, length of stay following readmission and time to readmission between day case and inpatient groups. Conclusions Day case surgery should be considered as an alternative to inpatient surgery for excisional haemorrhoidectomy and can be achieved without increase in hospital readmissions.