[Outpatient laparoscopic fundoplication for gastroesophageal reflux disease].
BACKGROUND
Day-case laparoscopic fundoplication for gastro-oesophageal reflux disease was introduced in January 1997.


METHODS
Inclusion criteria were ASA grade 1-2, living within 30 minutes by car from the hospital, or staying over in the patient hotel the first night, with company. Initially, only selected patients were offered day-case treatment; later it was adopted as routine. The patients underwent general intravenous anaesthesia with propofol and remifentanil and were given prophylaxis against postoperative pain and nausea. The surgical procedure was Nissen-Rossetti fundoplication or semifundoplication.


RESULTS
83 patients were included. Ten patients were admitted, 73 (88%) were discharged as planned 3-8 hours after the operation. Eight patients (10%) were readmitted; one of them underwent reoperation for necrosis of the gastric fundus. Eight patients visited the outpatient department without need for readmission. At seven-day follow-up, 55 discharged patients (75%) were satisfied with the day-case treatment, nine (12%) were indifferent, and nine (12%) were dissatisfied, mostly because of pain. If offered a similar operation in the future, 50 patients (68%) would have preferred and 11 (15%) would have accepted day-case treatment; 12 (16%) would not.


CONCLUSIONS
Outpatient laparoscopic fundoplication is safe and well tolerated by the majority of patients.
Trondsen
Erik
E
Gastrokirurgisk avdeling, Ullevål universitetssykehus 0407 Oslo. erik.trondsen@ulleval.no
Johannessen
Hans Olaf
HO
Buanes
Trond
T
Raeder
Johan
J
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D017060:Patient Satisfaction