Nasosinusal Endoscopic Surgery as Major Out-Patient Surgery

Abstract

Functional endoscopic sinus surgery (FESS) is a useful and widespread technique that allows the treatment of a large number of nasal pathologies. Nevertheless, although many ENT operations are carried out on an out-patient basis, FESS procedures commonly require at least 1 day of hospital admission in many centres. To evaluate our experience in FESS as day-case, to study causes of unexpected overnight admission, and to identify any risk factors for failing to comply with early discharge. We studied 145 patients consecutively subjected to out-patient FESS procedures for chronic rhinosinusitis, antrochoanal polyps, and dacryocystorhinostomy from August 2004 to June 2007. We analyzed sex, age, medical history (arterial hypertension, asthma, Widal syndrome), pathology, associated septoplasty, extent of the surgery, and revision surgery. The re-admission rate was 13.1% with the following as the most frequent causes: bleeding (31.6%), requiring only observation in over half the cases (ie, without changing the nasal packing), and dizziness/weakness (36.8%). Only revision surgery was associated with an increase in the re-admission rate (odds ratio, 3.5; 95% CI, 1.2-10.1). Our experience in FESS for out-patient surgery shows a readmission rate of 13.1 %, although most cases were related to minor complications. The revision surgery was the only variable that could be associated with an increase in re-admission rate.