Ambulatory mastectomy.
BACKGROUND
Ambulatory mastectomy has been a topic of heated political debate with little analysis of clinical data.


METHODS
Based on extensive satisfaction surveys, an ideal surgical treatment experience was developed that decreased nausea, increased preoperative education, and reduced perioperative narcotic usage. Using this new algorithm, patients treated by a single surgeon were given the choice of overnight stay versus discharge to home with visiting nurse care.


RESULTS
From March 1 to October 31, 2001, 92 mastectomies or lumpectomy/axillary dissections were performed in 87 patients. One patient chose to remain in the center overnight. All others were discharged in less than 2.5 hours postoperatively. Perioperative complications fell to 20% of those of the prior year. Hospital charges fell 79.5%.


CONCLUSIONS
Despite lay reservations about ambulatory mastectomy, a detailed approach can result in markedly reduced health care costs without incurring additional morbidity or mortality.
Dooley
William C
WC
University of Oklahoma Breast Institute, 825 NE 10th St., Suite 5200, Oklahoma Health Sciences Center, Oklahoma City 73104, USA.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000191:economics* / Q000592:standards; D001291:Attitude of Health Personnel; D005260:Female; D006699:Home Care Services / Q000191:economics / Q000592:standards; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008408:Mastectomy / Q000191:economics* / Q000592:standards; D008875:Middle Aged; D017060:Patient Satisfaction; D013531:Surgicenters / Q000191:economics*; D014481:United States