Open Hemorrhoidectomy With Ligasure™ Under Local or Spinal Anesthesia: A Comparative Study

Background There is increasing evidence that many anorectal surgical procedures may be performed under local anesthesia. The aim of the present study was to evaluate the safety and efficacy of local anesthesia in the outpatient clinic vs spinal anesthesia in the operating room for open hemorrhoidect...

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Bibliographic Details
Published in:The American surgeon 2023-04, Vol.89 (4), p.671-675
Main Authors: Feo, Claudio F., Ninniri, Chiara, Tanda, Cinzia, Deiana, Giulia, Porcu, Alberto
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Local
Anesthesia, Spinal
Anorectal
Bupivacaine
Comparative studies
Hemorrhoidectomy - methods
Hemorrhoids
Hemorrhoids - surgery
Hospitals
Humans
Local anesthesia
Medical personnel
Outpatient care facilities
Pain
Pain, Postoperative - prevention & control
Patient satisfaction
Postoperative period
Ropivacaine
Surgery
Treatment Outcome
Urinary retention
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Summary:Background There is increasing evidence that many anorectal surgical procedures may be performed under local anesthesia. The aim of the present study was to evaluate the safety and efficacy of local anesthesia in the outpatient clinic vs spinal anesthesia in the operating room for open hemorrhoidectomy. Methods Sixty-two patients with grade III or IV hemorrhoids underwent open hemorrhoidectomy with LigaSure™ between 2018 and 2020. Of them, 32 procedures were performed in the operating room under spinal anesthesia with hyperbaric bupivacaine and other 30 procedures were undertaken in the outpatient clinic under local anesthesia with ropivacaine. Results There were no significant differences regarding age, gender, American Society of Anesthesiologists class, and Goligher’s grade in between groups. No significant differences were observed in postoperative pain score (P = .85), perioperative complications (P = .51), and reoperation rate (P = .96). No recurrences and no differences in patients’ satisfaction degree (P = .76) were documented at long-term follow-up in both study groups. Discussion Our results suggest that open hemorrhoidectomy with LigaSure™ performed in selected patients under local anesthesia in the outpatient clinic is a well-tolerated, safe, and effective procedure.
ISSN:0003-1348
1555-9823
DOI:10.1177/00031348211038590