[A comparative study of the feasibility and limits of ambulatory surgery in infants under and over one year of age].
OBJECTIVE
Outpatient surgery in pediatrics is attractive for several reasons. Although 6-8 months has been generally acknowledged as the lower age limit, no minimal age has been clearly established. This study evaluated the outcomes and limits of outpatient surgery in infants from 4 months to 1 year of age.


METHODS
Between 1996 and 2003, 935 patients were admitted to our hospital for outpatient surgery; of these, 152 were between 4 months and 1 year (mean: 6 months). The indications were essentially surgery to the external genitalia and surgery to remove hernias. The following were exclusion criteria: age below 4 months, ASA scores equal to or above 3, and premature birth with either respiratory distress syndrome or a near-miss of sudden death.


RESULTS
More than 98% of the infants met the criteria for outpatient surgery. Cancellations (1.97 vs. 0.51%, P > 0.05), conversions to classic hospitalization (0.65 vs. 0.37%, P > 0.05), postoperative complications (0.65 vs. 0.25%, P > 0.05), rehospitalization (0.65 vs.0.25%, P > 0.05) and relapse of the initial pathology (0.65 vs. 0.63%, P > 0.05) were not more frequent in these infants than in infants over 1 year.


CONCLUSIONS
Pediatric outpatient surgery can be proposed from the age of 4 months without increasing the postoperative risk, either anesthetic or surgical, included for selected former premature infants.
Kalfa
N
N
Service de chirurgie viscérale pédiatrique, CHU de Lapeyronie, 34295 Montpellier cedex 5, France. nicolaskal@aol.com
Forgues
D
D
Rochette
A
A
Lopez
M
M
Guibal
M P
MP
Sabatier-Laval
E
E
Allal
H
H
Galifer
R B
RB
D000367:Age Factors; D000556:Ambulatory Surgical Procedures / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male