Feasibility of laparoscopic Nissen fundoplication as a day-case procedure.
BACKGROUND
The aim of this prospective double-cohort pilot study is to evaluate the feasibility and desirability of laparoscopic Nissen fundoplication (LNF) performed in day-care when compared with laparoscopic cholecystectomy (LC) in day-care.


METHODS
Patients who underwent a LNF in day-care were prospectively evaluated. LNF patients were treated according to LC in day-care protocol. Outcome parameters were EQ-5D, visual analogue scale (VAS), and patient satisfaction.


RESULTS
From October 2005 to March 2008, 22 patients underwent LNF and 48 patients LC in day-care. After LNF, 21 out of 22 (95%) patients were discharged the same day. Seven (32%) patients were seen postoperatively in the Emergency Department with dysphagia or pain and two (9%) patients were readmitted. After LC, 45 out of 48 (94%) patients were discharged the same day. Six (12.5%) patients were seen postoperatively in the Emergency Department because of wound infection or pain and three (6%) were readmitted. EQ-5D and VAS scores were significantly worse after LNF in day-care (repeated measurements, p < 0.0001 and p < 0.0001). In a telephone survey 66.7% preferred a short hospital stay over day-care surgery after LNF compared with 30.9% after LC (p = 0.011).


CONCLUSIONS
LNF in day-care is feasible and safe, but postoperative pain scores are high and most prefer short hospital stay.
Vlug
Malaika S
MS
Department of Surgery, Academic Medical Center, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands.
Wind
Jan
J
Eshuis
Jan H
JH
Lindeboom
Robert
R
van Berge Henegouwen
Mark I
MI
Bemelman
Willem A
WA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000706:statistics & numerical data; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D010351:Patient Discharge / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D011788:Quality of Life; D055815:Young Adult