Outpatient Hemorrhoidectomy under Perianal Anesthetics Infiltration
Darin Lohsiriwat MD*, Varut Lohsiriwat MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University
Background : Hemorrhoidectomy is the most effective long-term treatment for hemorrhoids, mostly done in an
inpatient setting requiring general or spinal anesthesia.
Objective : To assess the safety and early post-operative results of outpatient closed hemorrhoidectomy under
perianal anesthetics infiltration.
Materials and Methods : A retrospective study of outpatient closed hemorrhoidectomy under perianal block
during March 2002 and May 2003 in an ambulatory facility of the Department of Surgery, Siriraj Hospital,
Bangkok.
Results : Fifty-five patients with third-degree or fourth-degree internal hemorrhoids underwent outpatient
closed hemorrhoidectomy under perianal block, including 40 males and 15 females. The mean age was 44.4
+ 12.2 years (21-72 years). Sites of hemorrhoidectomy at each operation were single 53%, double 42% and
triple 5%. Mean operative time was 20.7 + 9.9 minutes (5-60 minutes). Additional anal procedures were
performed in 6 cases. Severity of early postoperative pain were mild in 35% of the patients, moderate in 40%
of the patients and severe in 25% of the patients which could be relieved by oral analgesic drug, mostly lasting
less than three days. No postoperative urinary retention occurred. The patients could pass their stool in 1.2 +
0.8 days postoperatively (0-4 days). No postoperative complications were found in the present study. All
patients needed no hospital admission or an emergency department visit.
Conclusion : Outpatient hemorrhoidectomy under perianal anesthetics infiltration is effective and well toler-
ated. It should be an alternative approach in the treatment of hemorrhoidal disease.
Keywords : Outpatient hemorrhoidectomy, Perianal anesthetics infiltration, Ambulatory surgery
