HIỆU QUẢ CỦA PHẪU THUẬT CẮT TRĨ TRONG NGÀY DƯỚI GÂY TÊ TẠI CHỖ

Abstract

Background: Hemorrhoids are a benign anal disease that is not fatal but greatly affects the quality of life of patients. Currently, hemorrhoidectomy is still considered the most thorough treatment for grade III and grade IV hemorrhoids or those with thromboembolic complications. With the trend towards developing day surgery to serve patients' needs and reduce medical costs, it has become urgent to develop hemorrhoidectomy during the day under local anesthesia. Methods: A retrospective cohort study was performed on 55 patients who underwent hemorrhoidectomy under local anesthesia and 48 patients who underwent hemorrhoidectomy under spinal anesthesia at the Department of General Surgery, University Medical Center Ho Chi Minh City - Branch 2, between January 2018 to December 2022. Results: There was no difference in pain score according to the NRS scale and satisfaction level between the two study groups. However, postoperative urinary retention complications were recorded in the spinal anesthesia group at a rate of 6.3%, in contrast to none in the local anesthesia group (p=0.01). The operative time, overall hospital stay, and postoperative hospital stay were significantly longer in the spinal anesthesia group (p<0.001). The total hospital discharge costs of patients in the local anesthesia group were significantly lower than those in the spinal anesthesia group (7,685,055 ± 2,122,364 VND compared to 9,108,330 ± 2,267,286 VND, p=0.001, t-test). Conclusions: Hemorrhoidectomy under local anesthesia has no postoperative complications, shorter hospital stay, and lower medical costs than spinal anesthesia. The method of local anesthesia combined with intravenous sedation has shown feasibility in clinical practice.