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Haemorrhoidectomy by vessel sealing system under local anaesthesia in an outpatient setting: preliminary experience
Author(s) -
Luo C.H.,
Zang C.B.,
Zhang G.K.,
Liu H.Y.
Publication year - 2010
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2009.01833.x
Subject(s) - medicine , lidocaine , visual analogue scale , anesthesia , surgery , general anaesthesia , local anesthesia , outpatient clinic , prospective cohort study , patient satisfaction , outpatient surgery , defecation , pain score , ambulatory
Aim This prospective study was designed to assess the feasibility of local anaesthesia for LigaSure TM haemorrhoidectomy in an outpatient setting. Method From April 2006 to March 2007, 207 consecutive patients (median age 42, 126 males) with grade III (147) and grade IV (60) haemorrhoids, underwent Milligan–Morgan haemorrhoidectomy with LigaSure TM under local anaesthesia (lidocaine 1%, mean dose 27 ± 1.7 ml) in an outpatient setting. Postoperative pain was assessed by a visual analogue scale (VAS). Results Two, three and four files were removed in 120, 51 and 36 patients. Mean operative time was 12 ± 5.2 min and mean blood loss was 3.4 ± 3.9 ml. The mean postoperative pain scores were 6.2 ± 2.1 for the maximal pain intensity and 6.1 ± 2.5 for the pain on defecation. All patients left hospital after surgery within 2 h and 33 (15.9%) required analgesics. They returned to normal daily activity after 12.2 ± 7.9 days including work (12.1 ± 7.8 days). The wounds had healed by 32.2 ± 9.1 days. At a follow‐up of at least 6 months, only six cases of major bleeding had occurred and 24 patients had skin tags. The median satisfaction score was +2 (−2 to +3). Conclusion LigaSure TM haemorrhoidectomy under local anaesthesia in the outpatient setting is safe and effective.