OUTPATIENT HEMORRHOIDECTOMY UNDER LOCAL-ANESTHESIA

Objective: To compare early and late results and costs of outpatient h aemorrhoidectomy under local anaesthesia with those of inpatient haemo rrhoidectomy. Design: Prospective study with historical controls. Sett ing: University hospital, Brazil. Subjects: 51 patients who required h aemorrhoidectomy. Interventions: Outpatient haemorrhoidectomy under lo cal anaesthesia. Main outcome measures: Early and late results and com parative costs. Results: One patient was withdrawn from the study beca use of hypertension and subsequently lost to follow-up. The remaining 50 patients were discharged a mean of 68 (23) minutes after operation. Twelve patients complained of severe pain, one had faecal impaction a nd 2 developed bleeding. One patient developed urinary retention, comp ared with 18 in the historical group (p < 0.001). Forty-two patients ( 84%) were thoroughly satisfied with their treatment. Late complication s did not differ significantly from those observed in the historical g roup. The estimated hospital costs were US$ 313.6 for outpatient, and US$ 716 for inpatient treatment. Conclusion: Outpatient haemorrhoidect omy under local anaesthesia was safe and comfortable for most patients , with complication rates comparable to or better than those observed after inpatient treatment and at less than half the cost.