Unplanned Admission After Day-case Haemorrhoidectomy: A Retrospective Study

ObjectiveTo identify the risk factors associated with unplanned admission after day-case haemorrhoidectomy.MethodsThis was a retrospective review of the outcomes of patients who underwent elective, intended day-case haemorrhoidectomy in a surgical institution between January 2005 and December 2009. Data were generated from a computerized database. Information on patient demographics, type of surgery, mode of anaesthesia, operative time, operation end time, and perioperative drugs were collected and analysed. Unplanned admission was carefully recorded.ResultsIn a 5-year period, 243 patients underwent intended day-case haemorrhoidectomy. Of these, 43 (17.7%) had unplanned admission, with acute urinary retention as the most common cause (n = 30). Using univariate analysis, male gender, the use of spinal anaesthesia, and a late operation end time of after 2 PM were found to be positive risk factors associated with unplanned admission, whereas the use of single-dose dexamethasone during induction was identified as having a negative effect on unplanned admission. However, multivariate analysis showed that only male gender, the use of spinal anaesthesia, and a late operation end time of after 2 PM were independent risk factors.ConclusionGood operation listing and the use of general anaesthesia are recommended in the practice of day-case haemorrhoidectomy.