Same-day discharge for laparoscopic Heller myotomy.

Abstract

Laparoscopic Heller myotomy is an effective treatment for achalasia. There are little data on the safety and feasibility of same-day discharge after laparoscopic Heller myotomy. This study aimed to describe the experience with same-day discharge after laparoscopic Heller myotomy at one hospital. A retrospective cohort study including all patients who underwent laparoscopic Heller myotomy between 2007 and 2016 at University Health Network (UHN), Toronto, Canada. There was no consent required as the study was retrospective study. This study was approved by the UHN IRB. Planned same-day discharge patients were compared to planned inpatient with respect to post-op complications, length of stay, and number of emergency visits. A total of 209 patients were identified. Same-day discharge was planned in 67 (33.5%) cases compared to 133 (66.5%) cases that were planned for inpatient. The study population was 49% male. On average, inpatients had 2.3 pre-operative comorbidities and same-day discharge patients had 1.6 pre-operative comorbidities. The average length of stay for the inpatient group was 3.5 days. Among the same-day surgery group, 15 had an unplanned admission following surgery (22%). Of those who were admitted, the average length of stay was 1.27 days. Only 1 same-day discharge was readmitted after hospital discharge, while 4 in inpatient group were readmitted.Thepost-operativecomplicationratewas (15%)20 of inpatientcompared to four (6.0%) of same-daydischarge. Number of emergency visits for inpatient groupwere 7 (5.3%) compared to 3 (4.5%) for same-day dischargegroup.There was one mortality case ininpatient group due to post-op complication. Same-day surgery is feasible for laparoscopic Hellermyotomy, with a similarcomplication and readmission rate as inpatient surgery.