Day surgery unit thoracic surgery: the first UK experience.

Objective: Operating in a day surgery unit has potential benefits, including lower risk of cancellation, reduced infection rates, cost effectiveness and increased patient satisfaction. We believe that we are the first unit in the UK to regularly perform thoracic surgery in a dedicated day surgery unit, and describe our experience to date.

Methods: Data were collected prospectively from 1 September 2007 to 31 December 2009. Following surgery, patients were observed in a recovery area for 1h before transfer back to a short-stay ward. When chest drains were used, they were attached to an ambulatory drainage device for the patient to be discharged with. All patients were reviewed postoperatively, and were discharged home within 4-6h if appropriate.

Results: Ninety-eight patients underwent thoracic surgery in our day surgery unit. Sixty (61.2%) patients were male. The mean age was 53.0 (17-83) years. There were no deaths. Twenty-nine (29.6%) were mediastinal procedures (MED group) such as mediastinoscopy/otomy, 31 (31.6%) were video-assisted thoracoscopic surgery (VATS group) procedures such as lung biopsies and pleurodeses and 38 (38.8%) were a variety of other (OTHER group) procedures such as chest wall interventions and sternal wire removal. Out of the cohort, three (3.1%) patients required admission directly from the day surgery unit, and three (3.1%) were admitted late after discharge with problems relating to their surgery. Our Day Surgery Programme accounted for 12.0% of the total thoracic workload during the time period.

Conclusions: Surgeons are continually trying to fast track increasingly complex procedures and, with good patient selection, thoracic surgery can be performed safely and effectively in day surgery units.