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A PROSPECTIVE RANDOMIZED TRIAL OF DAY‐STAY ONLY VERSUS OVERNIGHT‐STAY LAPAROSCOPIC CHOLECYSTECTOMY
Author(s) -
Hollington P.,
Toogood G. J.,
Padbury R. T. A.
Publication year - 1999
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1046/j.1440-1622.1999.01713.x
Subject(s) - medicine , randomized controlled trial , randomization , nausea , surgery , vomiting , laparoscopic cholecystectomy , anesthesia , prospective cohort study , cholecystectomy
Background : Although the feasibility of laparoscopic cholecystectomy performed as day surgery has been established, cost and recovery time have not previously been evaluated in a prospective comparative fashion. Methods : Patients were randomized to day stay only or overnight stay, and a nurse assessed the former postoperatively at home. All patients were reviewed weekly or as required if problems occurred. Costing comparisons were made between the two groups using Trendstar software. Results : A total of 131 patients were evaluated after randomization (60 day‐stay only patients and 71 overnight‐stay patients). A total of 18.3% of the day‐stay patients required in‐hospital admission for nausea, vomiting, or pain, or after conversion to open operation; 18.3% of the overnight group required an extended length of stay for similar reasons. After discharge, two day‐stay and three overnight‐stay patients required readmission, only one had a significant complication. The mean times to return to normal activity averaged 1.8 weeks (SE: 0.1 weeks) and 1.9 weeks (SE: 0.1 weeks) for day‐stay and overnight‐stay groups, respectively ( P = 0.63), and costs of $2732 (SE: $76) compared to $2835 (SE $110), respectively ( P = 0.94). Conclusions : In the present randomized controlled study, day‐stay management did not compromise postoperative patient outcome. In the setting of a major teaching hospital there was no cost advantage when compared to overnight‐stay management.