Ambulatory surgery in emergency

Abstract

ObjectiveIn France, one of the major public health objectives is the increase of outpatient care in order to reduce hospital stay. This study reports the actual feasibility of setting up an ambulatory emergency surgery unit. Material and methods: A prospective observational study was conducted in our hospital. Patient’s characteristics, length of stay, patient’s phone calls, and readmission were colligated. Results are expressed in medians [interquartile 25–75%].ResultsFrom May 2011 to April 2012, 70 consecutive patients were aged 34 (26–44). Represented specialties were visceral surgery (56%), orthopedic surgery (37%), maxillofacial surgery (4%), and urologic surgery (3%). Among these 70 patients, 61 (87.2%) stayed in the outpatient procedure without any readmission, 4 (5.7%) were excluded for complex surgical follow-ups, 3 (4.2%) for lack of accompanying person when discharged, and 2 (2.8%) for nausea and vomiting. A patient call was made for insufficient analgesia. The average length of stay was of 11.2 [8.7–12.2] hours.ConclusionThe setting up of an ambulatory emergency surgery unit is possible after proper training of emergency care specialists, anesthesiologists, and surgeons. This activity is compatible with safe care of patients and must be considered as part of available emergency procedures and not as excluded by principle.