Day Case Varicose Vein Operations: Patient Suitability and Satisfaction

1995 ◽  
Vol 10 (3) ◽  
pp. 103-105 ◽  
Author(s):  
S. Ramesh ◽  
H. N. Umeh ◽  
R. B. Galland
Keyword(s):  
Postoperative Pain ◽  
General Hospital ◽  
Varicose Vein ◽  
Varicose Veins ◽  
District General Hospital ◽  
Separate Group ◽  
Day Case ◽  
District Nurse ◽  
Varicose Vein Operation ◽  
Discharge From Hospital

Objectives: To define how many patients with varicose veins are suitable to have the operation carried out as a day case. To define how well the procedure is tolerated. Design: A prospective 6-month study. Setting: District General Hospital. Patients: One hundred and sixty-eight new patients and a separate group of 100 patients having a day case varicose vein operation. Interventions: New patients were assessed according to RCS guidelines. Postoperatively, patients completed a one-page questionnaire. Results: Of the 168 patients, 141 (84%) were suitable for a day case operation. The main indications for an overnight stay were associated medical conditions and social problems. Of the 100 patients having an operation, 90 stated they would have a similar procedure carried out as a day case again. In the first 2 postoperative weeks, 12 patients saw their GP and three a district nurse. No patients contacted their GP before the fifth postoperative day. Twenty-eight patients took no analgesia following discharge from hospital; 81 felt that their postoperative pain was less than or as they expected. Conclusion: Most patients with varicose veins are suitable to have a day case procedure, which is well tolerated and provides no additional workload for the GP.

Feasibility of day case varicose vein surgery in a district general hospital

2000 ◽  
Vol 169 (1) ◽  
pp. 37-39 ◽  
Author(s):  
R. Mofidi ◽  
A. O. Bello ◽  
A. Mofidi ◽  
Z. Khan ◽  
S. Aly ◽  
...  
Keyword(s):  
General Hospital ◽  
Varicose Vein ◽  
District General Hospital ◽  
Day Case ◽  
Varicose Vein Surgery

scholarly journals Day case laparoscopic cholecystectomy: Identifying patients for a ‘COVID-Cold’ isolated day-case unit during the pandemic

2021 ◽  
pp. 175045892097741
Author(s):  
Zoe Hinchcliffe ◽  
Imran Mohamed ◽  
Anil Lala
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
General Hospital ◽  
Univariate Analysis ◽  
District General Hospital ◽  
Day Case ◽  
Patient Factors ◽  
Surgical Services ◽  
North Wales ◽  
Selection For ◽  
The Uk

Background The UK practice of laparoscopic cholecystectomy has reduced during the COVID-19 pandemic due to cancellation of non-urgent operations. Isolated day-case units have been recommended as ‘COVID-cold’ operating sites to resume surgical procedures. This study aims to identify patients suitable for day case laparoscopic cholecystectomy (DCLC) at isolated units by investigating patient factors and unexpected admission. Method Retrospective analysis of 327 patients undergoing DCLC between January and December 2018 at Ysbyty Gwynedd (District General Hospital; YG) and Llandudno General Hospital (isolated unit; LLGH), North Wales, UK. Results The results showed that 100% of DCLCs in LLGH were successful; 71.4% of elective DCLCs were successful at YG. Increasing age ( p = 0.004), BMI ( p = 0.01), ASA Score ( p = 0.006), previous ERCP ( p = 0.05), imaging suggesting cholecystitis ( p = 0.003) and thick-walled gallbladder ( p = 0.04) were significantly associated with failed DCLC on univariate analysis. Factors retaining significance (OR, 95% CI) after multiple regression include BMI (1.82, 1.05–3.16; p = 0.034), imaging suggesting cholecystitis (4.42, 1.72–11.38; p = 0.002) and previous ERCP (5.25, 1.53–18.00; p = 0.008). Postoperative complications are comparable in BMI <35kg/m2 and 35–39.9kg/m2. Conclusions Current patient selection for isolated day unit is effective in ensuring safe discharge and could be further developed with greater consideration for patients with BMI 35–39.9kg/m2. As surgical services return, this helps identify patients suitable for laparoscopic cholecystectomy at isolated COVID-free day units.

Audit of new long-stay patients in a district general hospital

1994 ◽  
Vol 11 (1) ◽  
pp. 42-43 ◽  
Author(s):  
Mathew Kurian ◽  
Shobha George ◽  
Clive G Ballard ◽  
Ramalingam NC Mohan ◽  
Stuart Cumella
Keyword(s):  
General Hospital ◽  
Antisocial Behaviour ◽  
District General Hospital ◽  
Primary Diagnosis ◽  
Psychiatric Ward ◽  
Psychiatric Unit ◽  
Prolonged Stay ◽  
Diagnosis Of Dementia ◽  
Rehabilitation Facilities ◽  
Discharge From Hospital

AbstractObjective: To describe the characteristics of “new” long-stay patients in a district general hospital psychiatric unit. Method: A “new” long-stay patient was defined as a patient aged 18 or more who on the census date had been in a district general hospital psychiatric ward for longer than six months but less than six years. There was no upper age limit but patients with a primary diagnosis of dementia were excluded from the study. Information about each patient was obtained from medical and nursing cases notes. Patients were interviewed by one interviewer to determine their views on discharge from hospital. All the members of the multi-disciplinary team were interviewed by one interviewer to obtain their judgements about future accommodation needs of the patients. Results: “New” long-stay patients are typically single in their mid-forties with no supportive relatives. Most have a primary diagnosis of schizophrenia. They have a long psychiatric history and the majority had been in hospital between 6 months and three years. The principle reasons for prolonged stay were persistence of active psychotic symptomatology, schizophrenic defect state, poor social skills and antisocial behaviour. Conclusion: A group of “new” long-stay patients have accumulated in Wolverhampton district general hospital psychiatric unit, despite modern methods of treatment and the availability of a good range of rehabilitation facilities. They are a diverse group including patients with a severe schizophrenic disorders, affective disorders, personality disorders and organic disorders. Ideally, if these patients are to be placed in the community, rather than remaining as inpatients, then placement would need to be in specialised facilities like hospital hostels.

scholarly journals Ear, Nose and Throat Day-Case Surgery at a District General Hospital

2009 ◽  
Vol 91 (2) ◽  
pp. 147-151 ◽  
Author(s):  
T Pézier ◽  
P Stimpson ◽  
RG Kanegaonkar ◽  
DA Bowdler
Keyword(s):  
General Hospital ◽  
District General Hospital ◽  
Information Management System ◽  
Day Case ◽  
Common Procedure ◽  
Admission Rates ◽  
Ent Surgery ◽  
Proxy Measure ◽  
South East England ◽  
The Uk

INTRODUCTION In 2000, The NHS Plan in the UK set a target of 75% for all surgical activity to be performed as day-cases. We aim to assess day-case turnover for ENT procedures and, in particular, day-case rates for adult and paediatric otological procedures together with re-admissions within 72 h as a proxy measure of safety. PATIENTS AND METHODS Retrospective collection of data (procedure and length of stay) from the computerised theatre system (Galaxy) and Patient Information Management System (PIMS) of all elective patients operated over one calendar year. The setting was a district general hospital ENT department in South East England. All ENT operations are performed with the exception of oncological head and neck procedures and complex skull-base surgery. RESULTS Overall, 2538 elective operations were performed during the study period. A total of 1535 elective adult procedures were performed with 74% (1137 of 1535) performed as day-cases. Of 1003 paediatric operations, 73% (730 of 1003) were day-cases. Concerning otological procedures, 93.4% (311 of 333) of paediatric procedures were day-cases. For adults, we divided the procedures into major and minor, achieving day-case rates of 88% (93 of 101) and 91% (85 of 93), respectively. The overall day-case rate for otological procedures was 91% (528 of 580). Re-admission rates overall were 0.7% (11 of 1535) for adults and 0.9% (9 of 1003) for paediatric procedures. The most common procedure for re-admission was tonsillectomy accounting for 56% of all adult re-admissions and 78% of paediatric re-admissions. The were no deaths following day-case procedures. DISCUSSION ENT surgery is well-suited to a day-case approach. UK Government targets are attainable when considering routine ENT surgery. Day-case rates for otology in excess of targets are possible even when considering major ear surgery.

Day Case Varicose Vein Surgery: Patient Health Outcome

2001 ◽  
Vol 16 (4) ◽  
pp. 160-163
Author(s):  
K. J. Sweeney ◽  
T. Cheema ◽  
S. O'Keefe ◽  
S. Johnston ◽  
P. Burke ◽  
...  
Keyword(s):  
Physical Function ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Well Being ◽  
Health Perception ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Population Norms ◽  
Patient Health ◽  
The Impact

Background: The success of day case varicose vein surgery (DCWS) is traditionally denned clinically. However, the patient's perception of his or her own health prior to and following DCWS has not been established. This study prospectively measured the health status of patients with varicose veins, compared this with established population norms and assessed the impact of DCWS on both general health perception and varicose vein symptoms. Method: Fifty-three consecutive patients undergoing DCWS over a 9 month period were enrolled in this study. The SF-36 health assessment questionnaire and a vein-symptom-specific questionnaire were administered on the morning of surgery, 7 weeks postoperatively and 1 year following surgery. All patients in this study underwent a standard varicose vein operation and followed a standard protocol of postoperative management. Results: DCWS population health scores were lower than general population norms preoperatively. There was a significant improvement in the 7 week postoperative group in physical function and health perception (p<0.05). One year after surgery physical function, health perception, mental health and physical role were significantly improved from preoperative scores (p<0.05). Symptom-specific scores demonstrated a sustained trend towards improvement over the postoperative year. Conclusion: Varicose veins are associated with diminished well-being. Day case varicose vein surgery improves patient health perception and symptoms and is the treatment of choice for suitable patients with varicose veins.

Day-Case Surgery: A Viable Alternative for Surgical Treatment of Varicose Veins

1987 ◽  
Vol 2 (2) ◽  
pp. 103-108 ◽  
Author(s):  
D.C. Berridge ◽  
G.S. Makin
Keyword(s):  
Patient Group ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Viable Alternative ◽  
Patient Treatment ◽  
Case Group ◽  
Day Case ◽  
Varicose Vein Surgery ◽  
Day Case Surgery ◽  
Case Surgery

One hundred and forty-eight patients (164 limbs) who had varicose vein surgery by the same consultant surgeon 3–10 years previously were reviewed; 61 patients had surgery as an in-patient and 87 as a day-case. The patients were reviewed to assess the efficacy and acceptability of day-case varicose vein surgery. There were no significant differences between the age and sex ratios of the patients. However, twice as many operations in the in-patient group included stripping of the long saphenous vein above the knee (χ2 = 4.2, P = 0.04). Fifteen in-patients had bilateral vein surgery as opposed to only one day-case patient. Fifteen patients suffered complications most of which were minor and were evenly distributed including wound infections (nine), reactionary haemorrhage/haematoma (four), deep vein thrombosis (one) and pulmonary embolus (one). The convalescent period before returning to work was similar in the two groups (U= 953, P= 0.28). The mean duration of stay for the in-patients was 3.9 ± 2.2 days. There was no significant difference in the period off work (day-case: 3.6 ± 2.0 weeks; in-patient: 4 ± 2.9 weeks), or in the length of follow-up (day-case: 6.01 ± 1.24 years; in-patient: 6.79 ± 1.71 years). In the period before review 11 patients in the in-patient group and 13 patients in the day-case group had further surgery or sclerotherapy for recurrent symptomatic varicose veins. At review five patients in the in-patient group and six patients in the day-case group had recurrent sapheno-femoral incompetence (χ2 = 0.1, P = 0.7). A total of 34 patients in both groups had recurrent varicose veins. Only four (4.6%) of the day-case patients expressed a preference for in-patient treatment if they were to have further surgery and 21 (34%) of the in-patient group would prefer day-case surgery. Day-case varicose vein surgery has not been shown to be inferior in terms of complications or recurrence rate. Patient acceptability is good and it is a viable alternative to in-patient treatment in suitable patients in areas with adequate district nurse facilities.

scholarly journals Erratum

1996 ◽  
Vol 116 (3) ◽  
pp. 383-383
Keyword(s):  
General Hospital ◽  
Broad Spectrum ◽  
Varicose Veins ◽  
District General Hospital ◽  
Operating Theatre ◽  
Necrotising Fasciitis ◽  
Tissue Sections ◽  
Intravenous Antibiotics ◽  
Epidemiol Infect ◽  
Gram Positive Cocci

Epidemiol. Infect. 115 (1995), 387–97K.Cartwright, M.Logan, C.McNulty, S.Harrison, R. George, A.Efstratiou, M.McEvoy and N.BeggA cluster of cases of streptococcal necrotising fasciitis in GloucestershirePage 389,final paragraph should read:Patient BThree days later (7 February), patient B underwent a routine sapheno-femoral disconnection for varicose veins in the same operating theatre. In the evening she developed diarrhoea which persisted overnight; gastroenteritis was suspected. Early the next morning she was re-examined by her surgeon and was transferred to the district general hospital at about midday. NF was suspected, broad-spectrum intravenous antibiotics were commenced and surgery arranged. The diagnosis was confirmed at operation. The affected tissues were excised and specimens sent for culture and histology. Chains of Gram-positive cocci were seen in tissue sections and later, S. pyogenes was isolated.

Clinical Relevance of Neovascularisation on Duplex Ultrasound in the Long-Term Follow-up after Varicose Vein Operation

1999 ◽  
Vol 14 (3) ◽  
pp. 118-122 ◽  
Author(s):  
M. G. De Maeseneer ◽  
I. F. Tielliu ◽  
P. E. Van Schil ◽  
S. G. De Hert ◽  
E. J. Eyskens
Keyword(s):  
Varicose Vein ◽  
Clinical Relevance ◽  
Varicose Veins ◽  
University Hospital ◽  
Duplex Scanning ◽  
Recurrent Varicose Veins ◽  
Varicose Vein Operation ◽  
Long Term Follow Up

Objective: To evaluate the clinical relevance of neovascularisation at the saphenous ligation site. Design: Long-term follow-up after previous varicose vein surgery in a single patient group. Setting: Vascular clinic of a university hospital. Patients: Eighty-two patients (106 limbs) with a mean follow-up period of 56 months after correct saphenous ligation were submitted to duplex scanning. Intervention: Clinical assessment and colour duplex scanning of all the operated limbs. Reintervention in 15 limbs with perioperative evaluation of recurrent veins. Main outcome measures: Limbs with and without recurrent varicose veins were classified according to the degree of neovascularisation: grade 0 = no new communicating veins, grade 1 = tiny new vein with diameter <4 mm, grade 2 = new communicating vein with diameter >4 mm and pathological reflux. On reintervention the presence of neovascular veins at the site of the previous ligation was checked. Results: In 68 limbs without recurrent varicose veins, grade 0 was observed in 50 limbs (74%), grade 1 in 12 limbs (18%) and grade 2 in six limbs (9%). In 38 limbs with recurrent varicose veins, grade 0 was diagnosed in eight limbs (21%), grade 1 in four limbs (11%) and grade 2 in 26 limbs (68%). In 15 limbs with recurrent varicose veins and grade 2 neovascularisation, reintervention confirmed the duplex findings. Conclusions: The presence of grade 2 neovascularisation was associated with the recurrence of varicose veins, suggesting a causal relationship.

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