title: Same-day discharge in benign esophageal surgery: a prospective cohort study.
abstract: Day-case esophageal surgery has been demonstrated to be safe in small prospective cohorts and only for laparoscopic fundoplication. The aims of this study are to assess the feasibility and safety of a large series of esophageal day-case surgeries, including laparoscopic Nissen fundoplication (LNF), Zenker diverticulectomy (ZD), and laparoscopic Heller myotomy (LHM) and to compare the outcomes among three procedures.This was a prospective, observational study of selected patients who underwent day-case LNF, ZD, and LHM between 2003 and 2013. Postoperative outcomes, the patients' satisfaction, and functional results were evaluated with dedicated scores and compared.Of the 427 patients who underwent surgery for those indications during the study period, 168 (39.3%) eligible patients underwent day-case procedures (134 LNF, 14 LHM, and 20 ZD). The overnight unplanned admission rate was 16.2% and was similar among the groups (P = 0.681). Ten patients were readmitted during the first postoperative week because of dysphagia (n = 6, all in the LNF group), flu-like syndrome (n = 1), and secondary perforation (n = 3, all in the LHM group). The unplanned seven-day readmission rate was significantly higher in the LHM group than in the ZD and LNF groups (P = 0.042). The 30-day rates of unplanned readmission and consultation were 8.9% (P = 0.300) and 4.8%, respectively. At follow-up, 87.5% of the patients were satisfied with day-case treatment, and the functional results were good for 81.4% of the patients.Day-case esophageal surgery is feasible for LNF and seems to be feasible for ZD. Safety criteria have not yet been met for LHM, requiring further adaptations.
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.
authors.forename: A
authors.initials: A
authors.lastname: Desbeaux
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.|Univ. Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean Pierre Aubert Neuroscience et Cancer, F-59000 Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Gronnier
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.|Univ. Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean Pierre Aubert Neuroscience et Cancer, F-59000 Lille, France.
authors.forename: G
authors.initials: G
authors.lastname: Piessen
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.
authors.forename: M
authors.initials: M
authors.lastname: Vanderbeken
authors.affiliation: Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.
authors.forename: N
authors.initials: N
authors.lastname: Ruolt
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Triboulet
authors.affiliation: Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.|Univ. Lille, Ambulatory Department, University Hospital Claude Huriez, Lille, France.|Univ. Lille, UMR-S 1172 - JPARC - Centre de Recherche Jean Pierre Aubert Neuroscience et Cancer, F-59000 Lille, France.
authors.forename: C
authors.initials: C
authors.lastname: Mariette
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D003680:Deglutition Disorders / Q000209:etiology; D004947:Esophagus / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult; D016672:Zenker Diverticulum / Q000601:surgery
keywords: Heller laparoscopic myotomy; Zenker diverticulectomy; day-case surgery; esophageal surgery; laparoscopic fundoplication