Day surgery for mucosal-hemorrhoidal prolapse using a circular stapler andmodified regional anesthesia

PURPOSE: In 1993, prolapse reduction using the circular stapler for the tre atment of hemorrhoidal disease was proposed. The procedure is characterized by minimum postoperative pain. In this study we evaluated the above techni que using regional anesthesia to identify the advantages and feasibility of stapled hemorrhoidectomy, with special focus on the efficacy of same-day d ischarge. METHODS: From December 1997 to November 1999, we performed 70 con secutive reduction corrections of mucosal hemorrhoidal prolapse using the circular stapler with regional anesthesia (a technical modification of Mart i's posterior perineal block). Our series included 41 males and 29 females with a mean age of 43.4 (range, 25-74) years. Three patients were affected bp second-degree hemorrhoids and 67 by third-degree hemorrhoids. RESULTS: S ixty-two patients were discharged three hours after the operation in good g eneral condition and without pain, whereas eight patients were discharged t he day after for early complications, consisting of two cases of early blee ding, three cases of urinary retention, and three cases of persistent sever e pain requiring prolonged medical treatment. CONCLUSION: Our study shows t hat, in selected cases, it is possible to perform day surgery for patients with hemorrhoidal disease using a circular stapler device when combined wit h regional anesthesia.