scholarly journals Day Case GreenLight Laser Photoselective Vaporisation of the Prostate (GL-PVP)

2021 ◽  
Vol 4 (3) ◽  
pp. e8-e16
Author(s):  
Matthew Trail ◽  
Daniel Good ◽  
Danielle Clyde ◽  
Katie Brodie ◽  
Steve Leung ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Prostate Volume ◽  
Waiting List ◽  
Day Case ◽  
Day Case Surgery ◽  
Greenlight Laser ◽  
Overnight Stay ◽  
Case Surgery

Background and ObjectiveIn recent years, GreenLight laser photoselective vaporisation of the prostate (GL-PVP) has emerged as the primary ablative surgical treatment option for symptomatic bladder outlet obstruction (BOO) secondary to benign prostatic enlargement (BPE). Unlike the reference procedure, monopolar-transurethral resection of the prostate (M-TURP), GL-PVP can be performed as a day case. As waiting list pressures continue to burden health boards across the UK, exacerbated by the COVID-19 pandemic, enhanced access to day case surgery to optimise patient flow is now of paramount importance. We evaluated the safety and feasibility of day case GL-PVP at our high-volume UK centre and identified predictors of a postoperative overnight stay. Material and MethodsWe performed a retrospective observational cohort study of all patients who underwent primary GL-PVP at a single institution between October 2016 and June 2021. All procedures were performed utilising the 180W GreenLight XPS™ laser therapy system. Various clinical, operative and functional data were collated, and outcomes were compared between patients who underwent day case surgery and those admitted overnight postoperatively. ResultsIn all, 538 patients underwent GL-PVP during the study period. Median patient age was 72 (interquartile range (IQR) 66–77), and median prostate volume was 62.5cc (IQR 45–90). Five hundred nineteen patients (96.5%) were discharged within 23 hours of admission, and 366 patients (68.0%) were managed as a true day case. Operative and functional outcomes were comparable between patients managed as a day case and those admitted overnight. There was higher patient-reported satisfaction and a lower rate of early hospital readmission in the day-case group. On univariate logistic regression analysis, patients aged ≥80 years (Odds Ratio 2.64 [95% Confidence Interval 1.65– 4.24], p = < 0.001), those with American Society of Anaesthesiologists (ASA) physical status classification score ≥3 (OR 1.92 [95% CI 1.33–2.78], p = < 0.001), those with prostate volume ≥80cc (OR 1.62 [95% CI 1.00–2.61], p = 0.05) and those in whom the operation time ≥60 minutes (OR 1.66 [95% CI 1.10–2.52], p = 0.02) were more likely to be admitted overnight following GL-PVP. On multivariate logistic regression analysis, age ≥80 (OR 2.64 [95% CI 1.47–4.73], p = 0.001) and ASA score ≥3 (OR 2.03 [95% CI 1.28–3.22], p = 0.003) remained predictive variables of an overnight stay. ConclusionFrom our observations of a large cohort of patients over a study period of almost five years, day case GL-PVP is a feasible concept and does not appear to compromise perioperative outcomes. With appropriate service redesign and optimisation of postoperative patient pathways, day case GL-PVP can be established in other centres and may have a role in alleviating waiting list pressures.

scholarly journals ‘True Day Case’ Laparoscopic Cholecystectomy in a High-Volume Specialist Unit and Review of Factors Contributing to Unexpected Overnight Stay

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
A. Solodkyy ◽  
A. R. Hakeem ◽  
N. Oswald ◽  
F. Di Franco ◽  
S. Gergely ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Preoperative Assessment ◽  
High Volume ◽  
District General Hospital ◽  
Day Case ◽  
Day Case Surgery ◽  
Overnight Stay ◽  
Same Day Discharge ◽  
Case Surgery ◽  
Overnight Stays

Introduction. Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstones. British Association of Day Case Surgery recommends at least 60% of LCs be performed as day cases. The aim of this study was to assess our rate of true day case LCs and review factors preventing same-day discharge. Methods. We prospectively collected data of all elective LCs performed in a district general hospital over 32 months. Results. 500 patients underwent LC during this period; 438 (88.2%) patients were planned day cases and 59 patients (11.8%) planned overnight stays. Of the planned day cases, 75.8% (n=332) were discharged on the same day and 106 (24.2%) had unexpected overnight stay (UOS). Most patients with BMI >35 and ASA3 planned day case patients were successfully discharged. Drain insertion, longer operations, and late recovery departure were the main reasons for UOS. There were more complications in this group compared to day cases. Conclusions. This unit has a high ‘true day case’ rate of 75.8%. High BMI and ASA3 should not be absolute contraindications to day case surgery. The majority of unexpected overnight stays are unavoidable but may be reduced by patient selection, stringent preoperative assessment, operation scheduling, and reduction in unnecessary drain insertion.

scholarly journals Eras reduces unplanned overnight stay following orthopaedic day case surgery

2014 ◽  
Vol 12 ◽  
pp. S58 ◽  
Author(s):  
Anwen Williams ◽  
Andrew Miller ◽  
Awen Iorwerth ◽  
David Morgan
Keyword(s):  
Day Case ◽  
Day Case Surgery ◽  
Overnight Stay ◽  
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 872 Audit - Unexpected Overnight Stay After Day-Case Surgery In ENT

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
H Darwich ◽  
M Dawoud ◽  
A Poulios
Keyword(s):  
Day Case ◽  
Day Case Surgery ◽  
Overnight Stay ◽  
Operative Complications ◽  
Case Surgery ◽  
Selection For ◽  
One Year ◽  
Operation Timing ◽  
Overnight Stays ◽  
Theatre List

Abstract Introduction The aim of this audit was to determine the compliance with guidelines regarding patient selection for day-case surgeries in ENT. Method Data was collected retrospectively and included all patients who underwent elective ENT surgeries over a one-year period at an NHS hospital. Factors considered included nature of the operation, timing, surgeon’s preference, as well as social circumstances. Results Out of 1101 intended day cases, 113 (10%) had an unexpected overnight stay. The major factor contributing to these overnight stays was the timing of the operation, where 85 cases had undergone surgery in the afternoon. Other factors included drain siting, saturation monitoring, post-operative complications, and social circumstances. Tonsillectomy-related and nasal procedures formed the majority of the procedures, with 74 cases in total. Conclusions We concluded that most overnight stay cases included in this audit could have been prevented. Careful theatre list planning by prioritizing day cases for morning lists may reduce these numbers significantly. Co-morbidities and social aspects may need to be explored when booking patients for theatres.

ANALISIS HUBUNGAN SARANA, PENGETAHUAN, DAN SIKAP BIDAN PRAKTIK MANDIRI DENGAN KEPATUHAN MENJALANKAN STANDAR PELAYANAN ANTENATAL CARE DI KOTA PADANGSIDIMPUAN

2019 ◽  
Vol 2 (1) ◽  
pp. 27-33
Author(s):  
Megawati Sinambela ◽  
Evi Erianty Hasibuan
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Logistic Regression Analysis ◽  
Care Service ◽  
Multivariate Logistic Regression Analysis ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The North

Antenatal care is a service provided to pregnant women to monitor, support maternal health and detect mothers whether normal or problematic pregnant women. According to the WHO, globally more than 70% of maternal deaths are caused by complications of pregnancy and childbirth such as hemorrhage, hypertension, sepsis, and abortion. Based on data obtained from the profile of the North Sumatra provincial health office in 2017, in the city of Padangsidimpuan in 2017 the coverage of ANC visits reached (76.58%) and had not reached the target in accordance with the 2017 Provincial Health Office strategy plan (95%). This type of research was an observational analytic study with a cross sectional design. The population in this study were independent practice midwives who were in the Padangsidimpuan, the sample in this study amounted to 102 respondents. The technique of collecting data used questionnaires and data analysis used univariate, bivariate and multivariate analysis with logistic regression analysis. Based on bivariate analysis showed that there was a relationship between facilities, knowledge and attitudes of independent midwives with compliance with the standards of antenatal care services with a value of p <0.05. The results of the study with multivariate logistic regression analysis showed that the factors associated with the compliance of independent midwives in carrying out antenatal care service standards were attitudes with values (p = 0.026).

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.

scholarly journals Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Atsushi Kotera
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Postoperative Pain ◽  
Logistic Regression Analysis ◽  
Pain Control ◽  
Multivariate Logistic Regression Analysis ◽  
Multivariate Logistic Regression ◽  
Postoperative Pain Control ◽  
Flurbiprofen Axetil ◽  
Postanesthetic Shivering

Abstract Background Postanesthetic shivering is an unpleasant adverse event in surgical patients. A nonsteroidal anti-inflammatory drug has been reported to be useful in preventing postanesthetic shivering in several previous studies. The aim of this study was to evaluate the efficacy of flurbiprofen axetil being a prodrug of a nonsteroidal anti-inflammatory drug for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries. Method This study is a retrospective observational study. I collected data from patients undergoing gynecologic laparotomy surgeries performed between October 1, 2019, and September 30, 2020, at Kumamoto City Hospital. All the patients were managed with general anesthesia with or without epidural analgesia. The administration of intravenous 50 mg flurbiprofen axetil for postoperative pain control at the end of the surgery was left to the individual anesthesiologist. The patients were divided into two groups: those who had received intravenous flurbiprofen axetil (flurbiprofen group) and those who had not received intravenous flurbiprofen axetil (non-flurbiprofen group), and I compared the frequency of postanesthetic shivering between the two groups. Additionally, the factors presumably associated with postanesthetic shivering were collected from the medical charts. Intergroup differences were assessed with the χ2 test with Yates’ correlation for continuity category variables. The Student’s t test was used to test for differences in continuous variables. Furthermore, a multivariate logistic regression analysis was performed to elucidate the relationship between the administration of flurbiprofen axetil and the incidence of PAS. Results I retrospectively examined the cases of 141 patients aged 49 ± 13 (range 21-84) years old. The overall postanesthetic shivering rate was 21.3% (30 of the 141 patients). The frequency of postanesthetic shivering in the flurbiprofen group (n = 31) was 6.5%, which was significantly lower than that in the non-flurbiprofen group (n = 110), 25.5% (p value = 0.022). A multivariate logistic regression analysis showed that administration of flurbiprofen axetil was independently associated with a reduced incidence of postanesthetic shivering (odds ratio 0.12; 95% confidence interval, 0.02-0.66, p value = 0.015). Conclusions My result suggests that intraoperative 50 mg flurbiprofen axetil administration for postoperative pain control is useful to prevent postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries.

Sign in / Sign up

Export Citation Format

Share Document