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Analysis of the efficacy of pediatric day surgery
M Letts1, D Davidson, W Splinter
1Department of Surgery, Children's Hospital of Eastern Ontario, University of Ottawa.
Insights
Pediatric day surgery is safe and effective, benefiting children and families. This ambulatory surgery program at The Children's Hospital of Eastern Ontario (CHEO) demonstrated low complication rates and no permanent disabilities.
Area of Science:
- Pediatric Surgery
- Ambulatory Care
- Healthcare Program Evaluation
Background:
- The implementation of pediatric day surgery programs aims to improve patient outcomes and resource utilization.
- Assessing the safety and efficacy of such programs is crucial for optimizing pediatric surgical care.
Purpose of the Study:
- To evaluate the safety and effectiveness of a pediatric day surgery program.
- To determine the benefits of the ambulatory surgery program for children and their families.
Main Methods:
- Prospective data analysis of children undergoing day surgery at The Children's Hospital of Eastern Ontario (CHEO) from 1992 to 1997.
- Review of all surgical procedures, complications, and unexpected admissions within the day surgery program.
Main Results:
- The program served an average of 4,899 children annually, with common procedures including myringotomy, tonsillectomy/adenoidectomy, dental work, and inguinal hernia repair.
- Complication rates were low at 1.6% annually, with postoperative bleeding being the most frequent issue, primarily after tonsillectomy and adenoidectomy.
- No permanent disabilities or deaths were reported, indicating a high safety profile.
Conclusions:
- Pediatric day surgery is a safe and effective model of care.
- The ambulatory surgery program offers significant benefits to pediatric patients, their families, and the healthcare system.
- This model of care is cost-effective and enhances the pediatric surgical program.
Objectives:
To assess the efficacy and safety of a pediatric day surgery program and its benefits to the child and family.
Design:
A review and analysis of prospectively gathered data.
Setting:
The Children's Hospital of Eastern Ontario (CHEO), a university-affiliated pediatric centre with a referral base of 2.5 million people.
Patients:
All children undergoing day surgery at CHEO during the 5 years between 1992 and 1997.
Interventions:
All surgical procedures performed on a day surgery basis.
Main Outcome Measures:
Procedures performed, complications and unexpected admissions.
Results:
An average of 4,899 children per year underwent surgical procedures in the ambulatory day surgery program. The 4 commonest procedures performed were myringotomy, tonsillectomy and adenoidectomy, dental procedures, and inguinal hernia repair. The majority of children were between 2 and 7 years of age. Complications were few, averaging 1.6% per year, with postoperative bleeding, primarily secondary to tonsillectomy and adenoidectomy, being the most common. None resulted in permanent disability and there were no deaths.
Conclusions:
Pediatric day surgery is a safe and cost-effective program that benefits the child, the family and the pediatric surgical program.