The aim of the study was the evaluate of results of 2000 surgical operations for ano-
rectal disease performed in the
day-surgery setting (7-24 hours
hospital stay) with improvement of both cost effectiveness and patient comfort. From January 1980 to December 1998, 2000 patients underwent surgical operations: 1011 for haemorrhoids; 708 for
anal fissure; 172 for
fistula in ano; 80 for pylonidal disease; and 45 for anal
stenosis. 97.6% of patients were operated on with loco-regional anaesthesia; the others with
narcosis and peripheral anaesthesia. The
hospital-stay was 24 hours in 697 patients (34.5%), while 1319 (65.5%) operated on under loco-regional anaesthesia were hospitalised for 7-10 hours. Three patients (0.2%) developed acute
hemorrhage after hemorroidectomy during the immediate postoperative period. They underwent reintervention under general anaesthesia with a
hospital stay of 7 days. Four patients (0.6%) with perianal
abscess after
internal sphincterotomy underwent incision 10 days after the operation. Two patients with perianal
hematoma after
sphincterotomy prolonged the
hospital stay for three days. In 1048 patients (51.9%) clinical recovery was observed at first follow-up (7 days); 48% had recovered at the 2nd follow-up (14 days). In 1608 patients (98%) anatomical recovery was observed at the follow-up three months after surgery. Patient satisfaction 6 month after operation was high in 79%; good in 27%; low in 1%. These results seems confirm the feasibility of proctological
day surgery in almost all patients, with both a considerably cost reduction and enhanced patient comfort and compliance.