Day-case laparoscopic Nissen fundoplication.
BACKGROUND
The aim was to assess the acceptability and safety of day-case laparoscopic fundoplication for gastro-oesophageal reflux disease (GORD).


METHODS
This prospective study commenced in December 1999 and lasted for 18 months. All patients had proven symptomatic GORD. Inclusion criteria were American Society of Anesthesiologists grade I or II with adequate home support. A standard anaesthetic, analgesic and antiemetic protocol was used. Patients were contacted by telephone on the night of discharge and arrangements were made for a nurse to visit the following day. Postoperative pain and nausea were assessed using visual analogue scores (scale 0-10) on a self-completion questionnaire.


RESULTS
Twenty patients were included. There were no postoperative complications. All patients were discharged on the day of surgery. Median time to discharge was 6 h 30 min (range 4.5 to 9 h). One patient reattended casualty the following morning but none required readmission. There was no significant difference in median pain or nausea scores the evening after surgery or the next morning. All patients were satisfied with the information given and aftercare provided. All would recommend it to a friend and 19 of 20 would undergo the procedure as a day case again.


CONCLUSIONS
This study suggests that day-case laparoscopic fundoplication is feasible. Patients find it acceptable and it appears safe.
Bailey
M E
ME
Minimal Access Therapy Training Unit, Royal Surrey County Hospital, Egerton Road, Guildford GU7 5XX, UK. meb@mattu.org.uk
Garrett
W V
WV
Nisar
A
A
Boyle
N H
NH
Slater
G H
GH
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods* / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D018662:Fundoplication / Q000379:methods* / Q000592:standards; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000592:standards; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome