Day-case surgery is possible in the majority of men undergoing transurethral resection of the prostate – a report on over 1000 cases

2018 ◽  
Vol 11 (6) ◽  
pp. 403-408
Author(s):  
L Lavan ◽  
G Kyriazis ◽  
D Mbiabjeu ◽  
R Gormley ◽  
S Hall ◽  
...  
Keyword(s):  
Transurethral Resection ◽  
Inpatient Admission ◽  
Case Group ◽  
Day Case ◽  
Readmission Rates ◽  
Level Of Evidence ◽  
Day Case Surgery ◽  
Admission Rates ◽  
Case Surgery ◽  
Based Medicine

Objective: We describe our experience of performing bipolar transurethral resection in saline (Olympus Medical) as a day-case procedure over an initial five-year period. Patients and methods: All procedures coded as transurethral resection of the prostate over a 60-month period were analysed to determine whether the procedure was planned as a day-case or as an inpatient admission, and whether post-operative discharge proceeded as intended. Re-admission rates, reasons for re-admission and transfusion rates were also recorded. Results: Of the 1035 operations, 689 (66.57%) were planned as a day-case procedure (mean age 70.5 years) with 176 (25.5%) requiring inpatient admission, and 346 (33.43%) were planned for inpatient admission (mean age 73.6) but 58 (16.8%) were discharged the same day. Overall 571 (55.17%) procedures were performed as day cases. Readmission rates for day-case and inpatient procedures were 7.4%, and 6.3% respectively ( p=0.48). Transfusion rates were lower in the day-case group (0.7% vs 3.7%, p<0.05). Day-case rates improved from 48.70% in 2011 to 75.22% in 2016. Conversion from day case to inpatient fell from 34.6% in 2011 to 14.8% in 2016. Conclusions: Our experience indicates that day-case transurethral resection of the prostate can be performed safely in appropriately selected patients, without increased rates of re-admission or complications. Level of evidence: 4 (Oxford Centre for Evidence-Based Medicine (CEBM)).

Day case primary trans-urethral resection of bladder tumour (TURBT) as standard in a single UK centre. Should this be the new norm?

2020 ◽  
Vol 13 (4) ◽  
pp. 273-278
Author(s):  
Tomas Austin ◽  
Richard Robinson ◽  
Daniel Wilby ◽  
Stuart Hall ◽  
Dominic Hodgson
Keyword(s):  
Bladder Tumour ◽  
Inpatient Admission ◽  
Detrusor Muscle ◽  
Day Case ◽  
Recurrence Rates ◽  
Level Of Evidence ◽  
Admission Rates ◽  
Case Surgery ◽  
Muscle Invasive ◽  
Tumour Characteristics

Objectives: A retrospective study was conducted to examine the feasibility and safety of performing trans-urethral resection of bladder tumour (TURBT) in newly diagnosed patients as a day case operation. Patients and methods: All patients who underwent a primary TURBT over a 12 month period were included. Data were collected on patient demographics, tumour characteristics, day case vs. inpatient admission, indications for inpatient admission, re-admission rates within 28 days, and surrogate markers for quality of resection including recurrence rates. Results: A total of 172 patients were included. TURBT was performed as a day case procedure on 138 patients (80.2%). Rates of re-admission within 28 days were 7.2% and 5.9% in the day case and inpatient cohorts respectively. One hundred and thirty (75.6%) patients had non-muscle invasive bladder cancer (NMIBC). Of these, 84 (64.6%) were found to have detrusor muscle in their specimens, and 86 (66.2%) received peri-operative mitomycin C. Twelve month recurrence rates were 12%, 27% and 33% for low, intermediate and high-risk NMIBC respectively. Conclusion: This study shows that day case surgery for TURBT is feasible in the majority of patients, with a low rate of re-admission. Our data suggest that day case TURBT is suitable as standard practice in our institution and should be considered by others. Level of evidence: 2b.

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 Day case surgery: geographical variation, trends and readmission rates.

1989 ◽  
Vol 43 (3) ◽  
pp. 301-305 ◽  
Author(s):  
J Henderson ◽  
M J Goldacre ◽  
M Griffith ◽  
H M Simmons
Keyword(s):  
Geographical Variation ◽  
Day Case ◽  
Readmission Rates ◽  
Day Case Surgery ◽  
Case Surgery ◽  
Variation Trends

scholarly journals A RETROSPECTIVE REVIEW OF OTORHINOLARYNGOLOGY, AND HEAD AND NECK DAY CASE SURGERY READMISSION RATES AND COMPLICATIONS.

2017 ◽  
Vol 5 (4) ◽  
pp. 1792-1797
Author(s):  
AbdullahMohammed Ghafouri ◽  
◽  
Mustafa AbdullahAqeel ◽  
ShehabAbdulkareem Abusafia ◽  
WafaaAbdullah Magboul ◽  
...  
Keyword(s):  
Head And Neck ◽  
Retrospective Review ◽  
Day Case ◽  
Readmission Rates ◽  
Day Case Surgery ◽  
Case Surgery

Transurethral resection of bladder tumour as day-case surgery: Evidence of effectiveness from the UK Getting it Right First Time (GIRFT) programme

2019 ◽  
Vol 13 (3) ◽  
pp. 221-227
Author(s):  
William K Gray ◽  
Jamie Day ◽  
Tim WR Briggs ◽  
Simon Harrison
Keyword(s):  
Transurethral Resection ◽  
Bladder Tumour ◽  
Tumour Resection ◽  
Hospital Data ◽  
Day Case ◽  
Data Set ◽  
Day Case Surgery ◽  
Overnight Stay ◽  
Case Surgery

We aimed to investigate outcomes of transurethral resection of bladder tumour (TURBT) surgery when performed as day-case surgery compared to outcomes for patients who stayed ⩾ 1 night in hospital. Data were taken from the 2017–2018 Hospital Episodes Statistics data set, which contains data for all TURBT procedures conducted within the National Health Service in England. Data were categorised as those seen as day-cases and those that involved an overnight stay. Of 19,383 TURBT procedures, 3466 (17.9%) were classified as day-case surgery. Those who had an overnight stay were significantly older and were significantly more likely to be male, and have significantly greater frailty and comorbidity. After adjusting for confounders, those with an overnight stay had significantly poorer outcomes with regard to mortality and emergency readmission rates. Comparing trusts with the highest and lowest rate, of overnight stay, there were no differences in the profiles of the patients seen or in outcomes. Patients undergoing TURBT as day-case surgery have at least as good outcomes as those having an overnight stay. Investigation of the technical quality of the tumour resection, patient experience and quality of life after day-case surgery for TURBT would provide further insight. Evidence level: 2b

scholarly journals Comparison of Propofol and Thiopentone Anaesthesia (with Special Reference to Recovery Characteristics)

1987 ◽  
Vol 15 (4) ◽  
pp. 389-393 ◽  
Author(s):  
W. M. Weightman ◽  
M. Zacharias
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Day Case ◽  
Early Recovery ◽  
Day Case Surgery ◽  
Pain On Injection ◽  
High Incidence ◽  
Case Surgery ◽  
Repeated Doses ◽  
The Mean

Thiopentone and propofol were used for the induction and maintenance of anaesthesia in unpremedicated patients undergoing minor gynaecological procedures. There were no significant differences in the induction and maintenance characteristics except for a high incidence of pain on injection and a greater fall in the mean systolic blood pressure associated with propofol in comparison with thiopentone. Propofol was associated with a quicker early recovery as well as a faster psychomotor recovery, as tested by a peg-board. However, complete psychomotor recovery was not achieved for up to three hours in some patients receiving propofol and so caution is advised regarding the early street fitness of patients receiving repeated doses of the drug for day case surgery.

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