Feasibility of 23-hour hospitalization after laparoscopic fundoplication.
OBJECTIVE
In order to reduce the costs of laparoscopic fundoplication, a pilot program for outpatient surgery was instituted in 1995. The risks and benefits of reducing postoperative hospitalization to < or =23 hours were assessed.


METHODS
Patients in ASA grade I or II (N = 22) with refractory gastroesophageal reflux disease underwent laparoscopic fundoplication over a 21-month period in a hospital-affiliated outpatient facility. The results were compared with those of a similar group of 16 patients whose surgery was performed on an inpatient basis.


RESULTS
Seventeen patients (77%) were discharged within 23 hours of surgery. The maximum length of stay was 3 days. There were no deaths. Nineteen patients (86%) reported excellent results. The average facility cost declined from $7,169 for the inpatient group to $4,588 for patients on operated under the outpatient protocol. The decrease resulted from a reduction in the cost of room, operating suite, supplies, and anesthesia.


CONCLUSIONS
Laparoscopic fundoplication can be performed safely in a hospital-affiliated outpatient setting, resulting in a significant reduction in procedure costs.
Narain
P K
PK
Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond 23298, USA.
Moss
J M
JM
DeMaria
E J
EJ
D000328:Adult; D000465:Algorithms; D000556:Ambulatory Surgical Procedures / Q000191:economics / Q000706:statistics & numerical data; D016022:Case-Control Studies; D005240:Feasibility Studies; D005260:Female; D018662:Fundoplication / Q000191:economics / Q000706:statistics & numerical data; D005764:Gastroesophageal Reflux / Q000601:surgery; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects