• Surgical endoscopy · Aug 2009

    Comparative Study Clinical Trial

    Feasibility of laparoscopic Nissen fundoplication as a day-case procedure.

    • Malaika S Vlug, Jan Wind, Jan H Eshuis, Robert Lindeboom, Mark I van Berge Henegouwen, and Willem A Bemelman.
    • Department of Surgery, Academic Medical Center, P.O. Box 22660, Amsterdam, 1100 DD, The Netherlands.
    • Surg Endosc. 2009 Aug 1; 23 (8): 1839-44.

    BackgroundThe 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.MethodsPatients 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.ResultsFrom 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).ConclusionsLNF in day-care is feasible and safe, but postoperative pain scores are high and most prefer short hospital stay.

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