Our Summary

The research paper is discussing a study that was conducted to compare the safety and effectiveness of two types of anesthesia (local and spinal) used during hemorrhoid removal surgery. The surgeries were either performed in an operating room or an outpatient clinic. The study involved 62 patients who had severe hemorrhoids and underwent surgery between 2018 and 2020. Half of the patients had their surgery under spinal anesthesia in an operating room, while the other half had their surgery under local anesthesia in an outpatient clinic.

The results showed that there were no significant differences between the two groups in terms of age, gender, medical classification, and severity of hemorrhoids. Additionally, there were no notable differences in post-surgery pain, complications during surgery, or need for a second surgery. There were also no cases of the hemorrhoids returning, and the satisfaction levels of the patients were similar in both groups.

In conclusion, the study suggests that hemorrhoid removal surgery performed under local anesthesia in an outpatient clinic is a safe and effective procedure. This means that patients with severe hemorrhoids can have their surgery done in a less intensive setting with local anesthesia and expect similar results as those who undergo the procedure in an operating room under spinal anesthesia.

FAQs

  1. Is local anesthesia safe and effective for open hemorrhoidectomy procedures?
  2. Does the type of anesthesia used (local or spinal) impact postoperative pain, perioperative complications, or reoperation rates in open hemorrhoidectomy procedures?
  3. What is the patient satisfaction rate for open hemorrhoidectomy procedures performed under local anesthesia in an outpatient clinic?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hemorrhoidectomy is to consider the option of undergoing the procedure under local anesthesia in an outpatient clinic setting. This approach has been shown to be safe, effective, and well-tolerated, with comparable outcomes to procedures performed under spinal anesthesia in a traditional operating room setting. Patients may experience less postoperative pain and have a quicker recovery time with this approach. It is important to discuss all available options with your doctor to determine the best course of treatment for your specific situation.

Suitable For

Patients with grade III or IV hemorrhoids are typically recommended for hemorrhoidectomy. These patients may experience severe symptoms such as significant pain, bleeding, and prolapse of the hemorrhoids. Additionally, patients who have not responded to conservative treatments such as dietary modifications, fiber supplements, and topical medications may also be candidates for hemorrhoidectomy. It is important for patients to discuss their individual symptoms and treatment options with a healthcare provider to determine if hemorrhoidectomy is the appropriate course of action for their condition.

Timeline

Before hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, itching, bleeding, and swelling.
  2. Patient consults with a healthcare provider who diagnoses the hemorrhoids and recommends a hemorrhoidectomy.
  3. Preoperative evaluation and preparation are done, including discussing the procedure, anesthesia options, and any necessary tests.
  4. Patient may be prescribed medications to manage symptoms and prevent infection.

After hemorrhoidectomy:

  1. Procedure is performed either in the operating room under spinal anesthesia or in the outpatient clinic under local anesthesia.
  2. Patient may experience some pain and discomfort after the procedure, which can be managed with pain medications and other measures.
  3. Follow-up appointments are scheduled to monitor healing and address any concerns.
  4. Long-term follow-up shows no recurrences and high patient satisfaction with the procedure.
  5. Patient is able to resume normal activities and enjoy relief from hemorrhoid symptoms.

What to Ask Your Doctor

  1. Is a hemorrhoidectomy the best treatment option for my condition?
  2. What are the potential risks and complications associated with a hemorrhoidectomy?
  3. How long is the recovery period after a hemorrhoidectomy?
  4. What type of anesthesia will be used during the procedure?
  5. Will I need to stay overnight in the hospital after the surgery?
  6. What can I do to prepare for the procedure and optimize my recovery?
  7. How soon after the surgery can I expect to resume normal activities?
  8. Are there any dietary or lifestyle changes I should make following the surgery?
  9. What is the likelihood of recurrence of hemorrhoids after a hemorrhoidectomy?
  10. How will the success of the procedure be measured and monitored?

Reference

Authors: Feo CF, Ninniri C, Tanda C, Deiana G, Porcu A. Journal: Am Surg. 2023 Apr;89(4):671-675. doi: 10.1177/00031348211038590. Epub 2021 Aug 12. PMID: 34382441