Major Ambulatory Surgery in Breast Diseases

Abstract

IntroductionThe use of ambulatory surgery (AS) for breast pathology (BP) has increased. The objective of this study is to analyse a group of patients treated surgically for breast pathology in order to evaluate its quality and security in a MAS setting in 2017. MethodsA retrospective review of all patients undergoing breast surgery was conducted within an AS programme from January to December 2017 in Consorcio Hospital General Universitario of Valencia (CHGUV). The number of patients, exclusion reasons, the type of surgical procedures, the evolution of substitution rate (SI), the rate and the causes of conversion to admission, the post-operatory complications, the motives of not including in the ambulatory program and the satisfaction rate of the patients operated with ambulatory surgery have been studied. This has been compared with a 2013 group. ResultsIn 2017, 396 procedures for BP were performed. 170 operations were carried out for benign and 226 for malignant. The SI for the global mammary pathology is 72.8%. The SI for benign pathology was 93.4%. The SI for malignant pathology was 57.2%, which has increased in the last years from 45.4% in 2013. The index of unexpected admission (TI) of the malignant pathology was 14.1%, while the TI in the benign pathology was 0.6%. Patients hospitalized for malignant pathology presented higher complications (17%) than ambulatory ones (8.5%) and benign (6.5%). ConclusionsAt the CHGUV, the SR has steadily increased in malignant pathologies. The unexpected hospitalization rate is determined by perioperative sentinel lymph node biopsy results. AS for the treatment of mammary pathology is efficient and safe.