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KMID : 0377220000250020081
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Medical Journal of Chosun Univercity
2000 Volume.25 No. 2 p.81 ~ p.87
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Outpatient surgery of benign anal diseases under local anesthesia
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Kim Byung-Chul
Park Sang-Heon
Kim Jung-Young
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Abstract
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Purpose : Benign anal disease has been operated in the ambulatory surgical unit. This is the clinical analysis of benign anal disease in the outpatient clinic.
Materials ðod : The clinical and statistical observation of 88 patients with anal disease were made, who had been operated at the outpatient clinic of the department of surgery, Chosun University Hospital from September 1998 to August 1999. Hemorrhoids(below third degree of internal hemorrhoid and external hemorrhoid), anal fistulas, anal fissures, and perianal abscess, anal polyps, skin tags were opreated. The operation methods were band ligation, semiclosed hemorrhoidectomy, lateral internal sphincterotomy, fistulotomy, incision and drainage, excision. Local anesthesia by 1% Lidocaine 20ml with 20ml 0.5% bupivacaine of pudendal nerve block were used at the time of opreation in all cases. No premedication and preanesthetic agents were used. Bowel prereration has not been done in all cases.
Results : The most common disease was hemorrhoid. The peak incidence was the age group of 40-49years(23%) and the male to female ratio was 1.25:1. The most frequently used operative method was hemorrhoidectomy and band ligation(27%). The most common complication was post-operative pain (40%). The main benefit of out-patient surgery is the possibility of recovery at home, which is more compatible, and cost effective.
Conclusion : The ambulatory anorectal surgery under local anesthesia is safe and effective method, with the additional advantage of the cost-saving and increase of available beds for the patients with more complex surgery.
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KEYWORD
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Ambulatory surgery, anorectal surgery
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