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Feasibility of 23-hour hospitalization after laparoscopic fundoplication
P K Narain1, J M Moss, E J DeMaria
1Medical College of Virginia Hospitals, Virginia Commonwealth University, Richmond 23298, USA.
Purpose:
In order to reduce the costs of laparoscopic fundoplication, a pilot program for outpatient surgery was instituted in 1995. The risks and benefits of reducing postoperative hospitalization to < or =23 hours were assessed.
Patients And Methods:
Patients in ASA grade I or II (N = 22) with refractory gastroesophageal reflux disease underwent laparoscopic fundoplication over a 21-month period in a hospital-affiliated outpatient facility. The results were compared with those of a similar group of 16 patients whose surgery was performed on an inpatient basis.
Results:
Seventeen patients (77%) were discharged within 23 hours of surgery. The maximum length of stay was 3 days. There were no deaths. Nineteen patients (86%) reported excellent results. The average facility cost declined from $7,169 for the inpatient group to $4,588 for patients on operated under the outpatient protocol. The decrease resulted from a reduction in the cost of room, operating suite, supplies, and anesthesia.
Conclusion:
Laparoscopic fundoplication can be performed safely in a hospital-affiliated outpatient setting, resulting in a significant reduction in procedure costs.
