Abstract

Introduction: Hemorrhoidectomy is the gold standard for the treatment of Grade III and IV hemorrhoids in those patients in whom medical treatment and changes in eating habits, hygiene and cessation of toxic substances are insufficient.

Objectives: To describe the experience of the Coloproctology Service of the Hospital Petrona Villegas de Cordero - San Fernando in performing hemorrhoidectomy with local anesthesia in the period between April 1, 2018 and March 30, 2019.

Materials and Methods: Through a retrospective descriptive analysis on a prospective database, surgical technique, complications and degree of satisfaction of 34 patients who underwent hemorrhoidectomy under local anesthesia are described. Those patients with Grade III and IV hemorrhoids limited to a single hemorrhoidal bundle are included. Those patients in whom another anus orifical pathology coexists, grade IV hemorrhoids of more than one bundle and those who present circumferential hemorrhoidal prolapse are excluded from the analysis. The surgical technique implemented was semi-closed in all cases.

Results: Of the 34 patients in the series, 82.35% were women and 17.65% men between 30 and 49 years old. 58.82% had Grade III hemorrhoids and 41.18% Grade IV hemorrhoids limited to a single hemorrhoidal bundle. 5.8% (n = 2) of the patients in the series presented complications, with 1 being an early complication and 1 being a late one. Regarding the degree of satisfaction, 94.11% of the patients in the series reported being between Grade I and II.

Conclusion: Hemorrhoidectomy by semi-closed technique with local anesthesia is a safe and effective procedure for the resolution of hemorrhoidal pathology, reducing hospital stay times, without modifying the standards of the technique when performed with spinal anesthesia, being able to enter into protocol of Ambulatory surgery.

Keywords: Hemorrhoidectomy; Grade III and IV Hemorrhoids

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