Stapled Hemorrhoidectomy With Local Anesthesia can be Performed Safely and Cost-Efficiently

Esser, S.E. van; Khubchandani, Indru T.; Rakhmanine, M

doi:10.1007/s10350-004-0550-y

Cited by 59 publications

(39 citation statements)

References 55 publications

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“…Cases of urosepsis were also seen concomitantly in a small number of patients with urinary retention. 22 Early fecal urgency was reported and reported rates ranged from 0 to 25%, with a median occurrence of 8.28%. 5 Early constipation was also reported in 5 patients (0.03%) and in 2 cases, a fecaloma resulted (0.014%).…”

Section: -16 Documented Complications Of Hemorrhoidopexy Porrettmentioning

confidence: 99%

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Porrett

2015

International Surgery

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A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion. Data extraction was conducted by both reviewers and entered and analyzed in Microsoft Excel. The search identified 784 articles and 78 of these were suitable for inclusion in the review. A total of 14,232 patients underwent a stapled hemorrhoidopexy in this review. Overall complication rates of stapled hemorrhoidopexy ranged from 3.3%-81% with 5 mortalities documented. Early and late complications were defined individually with overall data suggesting that early complications ranged from 2.3%-58.9% and late complications ranged from 2.5%-80%. Complications unique to the procedure were identified and rates recorded. Both early and late complications unique to stapled hemorrhoidopexy were identified and assessed.

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Section: -16 Documented Complications Of Hemorrhoidopexy Porrettmentioning

confidence: 99%

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Porrett

2015

International Surgery

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“…KHALIL et al (12) have found that postoperative resting and squeeze pressures were reduced by stapled method at 3 months but normal pressure profile was observed at 6-month evaluation. The frequent presence of muscle fibers in the pathologic specimen does not seem to lead to impaired continence, as pointed out by ESSER et al (6) .…”

Section: Postoperative Incontinencementioning

confidence: 56%

Stapled hemorrhoidectomy: present status

Lacerda‐Filho

Silva

2005

Arq. Gastroenterol.

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-Aim -To evaluate cost-effectiveness of stapled hemorrhoidectomy comparing its results with conventional technique. Source of data -We retrospectively analyzed the MEDLINE data basis from 2000 to 2004 studying randomized clinical trials which compared pain intensity, recovery period, return to work and occurrence of anal incontinence, in addition to postoperative complications and costs evaluation between stapled and conventional hemorrhoidectomy during different periods of follow-up. Conclusions -Stapled hemorrhoidectomy provides lesser postoperative pain and earlier return to work than conventional hemorrhoidectomy. However, its efficacy could not be determined, since rigorous prospective and randomized clinical trials with long-term follow-up periods and large size samples are not available at this time.

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“…This feeling is often uncomfortable; therefore, medication needs to be administered, to sedate the patients. Infiltration can be performed in combination with sedation, 17 or with general anesthesia as in this study. Another study has also combined these methods.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, ropivacaine causes vasoconstriction, which limits its blood absorption. 19 Alternatively, short-acting lidocaine 17 or bupivacaine 12 can also be used.…”

Section: Discussionmentioning

confidence: 99%

Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy

et al. 2017

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BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included. The local group (LG) received local infiltration (0.75% ropivacaine) under general anesthesia; the spinal group (SG) received subarachnoid block (2 ml of 0.5% bupivacaine). Analgesic supplementation consisted of fentanyl for LG and lidocaine for SG. Postoperative pain intensity, sphincter relaxation, lower-limb strength, time to discharge, analgesic dose over one week and adverse effects were assessed. RESULTS: Eleven LG patients (52.4%) required supplementation, but no SG patients. Pain intensity was higher for LG up to 120 min, but there were no differences at 150 or 180 min. There were no differences in the need for paracetamol or tramadol. Times to first analgesic supplementation and hospital discharge were longer for SG. The adverse effects were nausea, dizziness and urinary retention. CONCLUSIONS: Pain intensity was higher in LG than in SG over the first 2 h, but without differences after 150 and 180 min. Time to first supplementation was shorter in LG. There were no differences in doses of paracetamol and tramadol, or in adverse effects. REGISTRATION: ClinicalTrials.gov NCT02839538. RESUMO CONTEXTO E OBJETIVO:A analgesia pós-operatória e a recuperação precoce são relevantes para a alta hospitalar. O objetivo primário deste estudo foi comparar a eficácia analgésica da infiltração perianal e da anestesia subaracnóidea para hemorroidectomia. O objetivo secundário foi comparar o tempo para alta, efeitos adversos e complicações. TIPO DE ESTUDO E LOCAL: Estudo randomizado prospectivo e comparativo, no Hospital Dr. Mário Gatti. MÉTODOS: Foram incluídos 40 pacientes com idades 18-60 anos, na categoria 1 ou 2 de status físico da Sociedade Americana de Anestesiologistas. O grupo local (GL) recebeu infiltração local (ropivacaína a 0,75%) sob anestesia geral; o espinal (GS) recebeu bloqueio subaracnóideo (2 ml de bupivacaína a 0,5%). A suplementação analgésica foi com fentanil para GL e lidocaína para GS. Foram avaliados: intensidade da dor no pós-operatório, relaxamento do esfíncter, força dos membros inferiores, tempo de alta, dose de analgésico em uma semana e efeitos adversos. RESULTADOS: Onze (52,4%) pacientes em GL necessitaram de complementação, e nenhum em GS. A intensidade da dor foi maior para GL até 120 minutos, sem diferenças em 150 ou 180 minutos. Não houve diferenças na necessidade de paracetamol ou tramadol. O tempo para a primeira complementação analgésica e a alta hospitalar foram maiores para GS. Os efeitos adversos foram náuse...

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Stapled Hemorrhoidectomy With Local Anesthesia can be Performed Safely and Cost-Efficiently

Cited by 59 publications

References 55 publications

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Stapled hemorrhoidectomy: present status

Randomized clinical study on the analgesic effect of local infiltration versus spinal block for hemorrhoidectomy

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