Related Experiment Videos
Same-day discharge in benign esophageal surgery: a prospective cohort study
A Desbeaux1,2, C Gronnier1,2,3, G Piessen1,2,3
1Univ. Lille, Department of Digestive and Oncological Surgery, University Hospital Claude Huriez, Lille, France.
Summary
Day-case esophageal surgery, including laparoscopic Nissen fundoplication and Zenker diverticulectomy, is feasible and safe. However, laparoscopic Heller myotomy requires further safety adaptations for outpatient procedures.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Day-case esophageal surgery has shown promise in small studies, primarily for laparoscopic fundoplication.
- Expanding outpatient procedures requires evaluating feasibility and safety across different esophageal surgeries.
Purpose of the Study:
- To assess the feasibility and safety of a large series of day-case esophageal surgeries.
- To compare outcomes of laparoscopic Nissen fundoplication (LNF), Zenker diverticulectomy (ZD), and laparoscopic Heller myotomy (LHM) in an outpatient setting.
Main Methods:
- Prospective observational study of selected patients undergoing day-case LNF, ZD, and LHM between 2003 and 2013.
- Evaluation of postoperative outcomes, patient satisfaction, and functional results using dedicated scores.
Main Results:
- 168 of 427 eligible patients (39.3%) underwent day-case procedures (134 LNF, 14 LHM, 20 ZD).
- Overnight unplanned admission rate was 16.2%, similar across groups.
- Seven-day readmission rate was higher for LHM (P=0.042) due to perforations; LNF and ZD showed acceptable safety.
- 87.5% patient satisfaction and 81.4% good functional results at follow-up.
Conclusions:
- Day-case esophageal surgery is feasible for LNF and appears feasible for ZD.
- Safety criteria are not yet met for LHM in day-case settings, necessitating further modifications.