Investigating outcomes of different types of hemorrhoid surgery and anesthesia for patients with hemorrhoid

• Main Authors: Hsiu Ju Lin, 林秀如
• Other Authors: H. M. Tseng
• Format: Others
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/27597275103553507609

碩士 === 長庚大學 === 商管專業學院碩士學位學程在職專班醫務管理組 === 102 === Background: Hemorrhoids are a common problem and hemorrhoiddec- tomy is a frequently performed surgical procedure for such a problem. During a surgical hemorrhoidectomy, a diverse array of complications may occur with respect to the method of anesthesia and surgical procedures. This study aims to compare the medical outcomes of different surgical procedures combined with anesthesia types. Medical outcomes include postoperative pain, urination difficulty, and admission length in hemorrhoid inpatients. Methods: A retrospective chart review was conducted to collect data from patients received any of three different hemorrhoidectomy between 2009 and 2012 in a medical center in Northern Taiwan. A total of 347 hemorrhoid inpatients were valid for this analysis. Results: 1. Patients’ personal characteristics such as sex, age, anesthesia evaluation have no significant effects on the medical outcome. 2. Types of surgical procedures have a significant effect on postoperative pain (F=4.689, p<0.01) and difficulty in urination (F=2.947, p<0.05). For traditional and Ligasure surgery, local anesthesia resulted in less pain compared to spinal anesthesia. PPH surgery with spinal anesthesia was associated with less pain than local anesthesia. For all three surgerical procedures, local anesthesia was associated with less difficulty in urination compared to spinal anesthesia. Ligasure surgery combined with local anesthesia had a shorter length of stay than other combinations of surgical procedures and types of anesthesia. Conclusion: The combination of Ligasure procedure and local anesthesia is shown to be more cost-effective and result in the most favorable medical outcomes, such as less postoperative pain and lower incidence of difficulty in urination. The results of this study can provide healthcare administrators and surgeons suggestions concerning decision-making related to better quality of care for patients received hemorrhoidectomy.