Background: Laparoscopic Heller myotomy is an effective treatment for achalasia. There are little data on the safety and feasibility of same-day discharge after laparoscopic Heller myotomy.
Objective: This study aimed to describe the experience with same-day discharge after laparoscopic Heller myotomy at one hospital.
Methods: A retrospective cohort study including all patients who underwent laparoscopic Heller myotomy between 2007 and 2016 at University Health Network (UHN), Toronto, Canada. There was no consent required as the study was retrospective study. This study was approved by the UHN IRB. Planned same-day discharge patients were compared to planned inpatient with respect to post-op complications, length of stay, and number of emergency visits.
Results: A total of 209 patients were identified. Same-day discharge was planned in 67 (33.5%) cases compared to 133 (66.5%) cases that were planned for inpatient. The study population was 49% male. On average, inpatients had 2.3 pre-operative comorbidities and same-day discharge patients had 1.6 pre-operative comorbidities. The average length of stay for the inpatient group was 3.5 days. Among the same-day surgery group, 15 had an unplanned admission following surgery (22%). Of those who were admitted, the average length of stay was 1.27 days. Only 1 same-day discharge was readmitted after hospital discharge, while 4 in inpatient group were readmitted. The post-operative complication rate was (15%) 20 of inpatient compared to four (6.0%) of same-day discharge. Number of emergency visits for inpatient group were 7 (5.3%) compared to 3 (4.5%) for same-day discharge group. There was one mortality case in inpatient group due to post-op complication.
Conclusion: Same-day surgery is feasible for laparoscopic Heller myotomy, with a similar complication and readmission rate as inpatient surgery.
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http://dx.doi.org/10.1007/s00464-021-08951-8 | DOI Listing |
Surg Obes Relat Dis
December 2024
Department of Surgery, Henry Ford Health, Detroit, Michigan.
Background: Same-day discharge after sleeve gastrectomy (SDDSG) is being performed in select patient populations with increased regularity since 2020.
Objectives: To evaluate the impact of SDDSG on emergency department (ED) visits.
Setting: Academic and private practice bariatric surgery programs participating in a statewide quality improvement collaborative.
Cureus
November 2024
Division of Interventional Radiology, Columbia University Irving Medical Center, New York, USA.
Aim This study aims to evaluate the safety and efficacy of transjugular intrahepatic portosystemic shunt (TIPS) check and revision procedures performed in a freestanding interventional radiology (IR) outpatient facility. Methodology A total of 40 patients (male 31:female 9, median age 60 years old) underwent a TIPS check and/or revision at a freestanding IR outpatient facility between 2009 and 2017. Procedures were performed using a mobile C-arm unit under intravenous (IV) moderate sedation, with the patient discharged home on the same day.
View Article and Find Full Text PDFJ Robot Surg
December 2024
Mid-Florida Surgical Associates, Clermont, FL, 34711, USA.
Robotic assisted laparoscopy is increasingly popular for primary ventral and incisional hernia repair. A variety of robotic techniques have been described. More data is needed to evaluate the indications and benefits of these approaches.
View Article and Find Full Text PDFJ Bone Joint Surg Am
December 2024
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
Background: Total joint arthroplasty (TJA) is increasingly being performed as an outpatient (i.e., same-day discharge) procedure.
View Article and Find Full Text PDFTech Coloproctol
December 2024
Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, 9500 Euclid Avenue A-30, Cleveland, OH, 44195, USA.
Effective closure of both muscular and mucosal defects after endoscopic submucosal dissection (ESD) remains a technical challenge. Failure to adequately address such defects may increase the risk of delayed perforation. In this video case report, we demonstrate the application of the through-the-scope (TTS) tack system for defect closure following ESD in a patient with a cecal lesion.
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