title: [Outpatient or short-stay videothoracoscopy-assisted thoracic sympathectomy: anesthesia in 445 cases].
abstract: OBJECTIVE
  To demonstrate the safety of outpatient or short-stay bilateral videothoracoscopy-assisted thoracic sympathectomy.
  
  
  METHODS
  The medical records of 445 who underwent bilateral videothoracoscopy-assisted thoracic sympathectomy were reviewed; the same protocols were used to guide these outpatient or short-stay procedures in all cases. Intravenous anesthesia was provided. An orotracheal tube allowed for carrying out the sympathectomy procedure during short periods of apnea. A 2% lidocaine solution was infused through the thoracic drains, which were removed soon after surgery. Data on intraoperative respiratory variables, pain, and intra- and postoperative complications were gathered. The data for patients undergoing the procedure on an outpatient or short-stay basis were compared.
  
  
  RESULTS
  No significant differences in demographic or perioperative variables were found between the 2 groups. In 3.6% of the patients in the series, there was a record of a postoperative pulmonary complication: 4 therapeutic minithoracotomies; 1 subcutaneous emphysema without radiologic changes; 9 residual pneumothoraces, 2 requiring pleural drainage; 1 chylothorax; and 1 delayed hemothorax. With the exception of the late-developing hemothorax, all complications were diagnosed and treated in the immediate postoperative period. In the outpatient surgery group, unplanned admissions because of patient refusal to leave occurred in 6.5% of the cases.
  
  
  CONCLUSIONS
  The low incidence of complications, and especially the finding that complications are detected in the early recovery period, indicate that this procedure can be performed on an outpatient basis.
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Clínic, Universidad de Barcelona. ana.tejedor@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Tejedor
authors.forename: M T
authors.initials: MT
authors.lastname: Anglada
authors.forename: M
authors.initials: M
authors.lastname: Pons
authors.forename: M A
authors.initials: MA
authors.lastname: Callejas
authors.forename: C
authors.initials: C
authors.lastname: Gomar
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000771:Anesthesia, Intravenous / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D002916:Chylothorax / Q000209:etiology; D005260:Female; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D006945:Hyperhidrosis / Q000601:surgery; D007322:Instillation, Drug; D007442:Intubation, Intratracheal; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013352:Subcutaneous Emphysema / Q000209:etiology; D013562:Sympathectomy; D013900:Thoracic Nerves / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects; D055815:Young Adult
chemical_list: D008012:Lidocaine