Feasibility of laparoscopic Nissen fundoplication as a day-case procedure

Surg Endosc. 2009 Aug;23(8):1839-44. doi: 10.1007/s00464-008-0277-2. Epub 2009 Jan 1.

Abstract

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.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ambulatory Surgical Procedures / adverse effects
  • Ambulatory Surgical Procedures / methods*
  • Ambulatory Surgical Procedures / statistics & numerical data
  • Cholecystectomy, Laparoscopic / statistics & numerical data
  • Cohort Studies
  • Feasibility Studies
  • Female
  • Fundoplication / adverse effects
  • Fundoplication / methods*
  • Fundoplication / statistics & numerical data
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / etiology*
  • Pain, Postoperative / psychology
  • Patient Discharge / statistics & numerical data
  • Patient Satisfaction
  • Pilot Projects
  • Prospective Studies
  • Quality of Life
  • Young Adult