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Tailored anal block (TAB): a new anesthesia procedure for surgical treatment of hemorrhoids in an outpatient setting

  • C. Elbetti
  • F. CaminatiEmail author
  • I. Giani
  • F. Feroci
  • T. Zalla
  • M. Calussi
  • P. Dreoni
  • G. Talamo
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Introduction

Currently, several operations can be performed under local anesthesia in an outpatient setting. This reduces the number of hospital admissions and is cost effective. We propose a new local anesthesia technique for the surgical treatment of hemorrhoids called tailored anal block (TAB).

Patient selection

Selected patients with symptomatic hemorrhoids were treated in the outpatient department under local anesthesia. The exclusion criteria were American Society of Anesthesiologists (ASA) class > II, Lee Index (RCRI) for cardiac risk > 1, body mass index (BMI) > 40 kg/m2, age < 18 years, pregnancy, history of panic attacks. The hemorrhoidal disease was classified according to the Single Pile Hemorrhoid Classification (SPHC) [1] and to Goligher’s classification. SPHC considers the number of pathological piles (N), the presentation of internal and external pile, possible presence of fibrous pile (F), the presence of subversion of dentate line or congestion of external pile (E),...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All the authors of this article declare that all procedures performed in this study, which involved human participants, were in accordance with ethical standards of institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individuals participants included in the study.

References

  1. 1.
    Elbetti C, Giani I, Martellucci J (2015) The single pile classification: a new tool to classify haemorrhoidal disease and the comparison of treatment results. Updates Surg 67(4):421–426.  https://doi.org/10.1007/s13304-015-0333-0 CrossRefGoogle Scholar
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    Elbetti C, Giani I, Novelli E, Martellucci J, Feroci F (2017) Symptomatic pile tailored procedure. A new perspective for hemorrhoidal disease treatment. Ann Ital Chir 88:348–351Google Scholar
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    Elbetti C, Giani I, Dreoni P, Caminati F, Zalla T (2017) Tailored mucosectomy and haemorrhoidopexy (TM&H). A new surgical option for Goligher grade III haemorrhoids. Colorectal Dis 19(Suppl. 2):35–139.  https://doi.org/10.1111/codi.13798 (P536) Google Scholar
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    Selvasekar C, Suwanthanma W, Nivatvongs S, Hassan I (2007) Local anesthesia of upper anal canal for multiple rubber band ligation: description of technique and preliminary results. Dis Colon Rectum 50(9):1481–1483.  https://doi.org/10.1007/s10350-007-0299-1 CrossRefGoogle Scholar
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    Marti MC (1993) Loco-regional anesthesia in proctological surgery. Ann Chir 47(3):250–255Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • C. Elbetti
    • 1
  • F. Caminati
    • 1
    Email author
  • I. Giani
    • 1
  • F. Feroci
    • 1
  • T. Zalla
    • 1
  • M. Calussi
    • 1
  • P. Dreoni
    • 1
  • G. Talamo
    • 1
  1. 1.SOSD Proctologia USL Toscana CentroPratoItaly

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