Day-case surgery is increasing in popularity and more patients with multiple medical problems are being considered as suitable for this approach. However, the current recommendations exclude morbidly obese patients (body mass index > 35 kg.m(-2)). We present a review of 258 morbidly obese patients who have received treatment in our day-surgery unit. Our experience does not show any significant increase in unplanned admission rates or postoperative complications. In conclusion, we feel that morbid obesity alone should not be an exclusion criterion for day-case surgery.
Day‐case surgery is increasing in popularity and more patients with multiple medical problems are being considered as suitable for this approach. However, the current recommendations exclude morbidly obese patients (body mass index > 35 kg.m−2). We present a review of 258 morbidly obese patients who have received treatment in our day‐surgery unit. Our experience does not show any significant increase in unplanned admission rates or postoperative complications. In conclusion, we feel that morbid obesity alone should not be an exclusion criterion for day‐case surgery.
Methods: Patients (>18 yrs) undergoing sleeve gastrectomy or Roux-en-Y gastric bypass during 2013 at a single centre [N¼124; F¼71, M¼53]. A retrospective review of electronic patient records. Primary outcome was successful discharge <24 h of leaving theatre recovery. Patient, operative and peri-operative details were anaylsed to identify factors associated with failed discharge. Significance was set at p<0.05. Results: 17/124 (13.7%) of patients were discharged within 24hrs. Comorbidities (%Successful/%Failed groups), OSA (20/9, p¼0.09), Asthma (0/ 100, p¼0.09) and Diabetes (11/85, p¼0.5), and additional operative events (hernia repair/cholecystectomy/adhesiolysis) (0/100, p¼0.08) were not significantly associated with discharge. Successful discharge was more likely from Level 2 (27%/Total) than Level 1 care (12%/Total). Time to pharmacy conversion of medication to bariatric compatible medication was not associated, but time to prescription of discharge medication was (p¼0.02). Conclusion: Few patients are meeting current discharge targets. Efforts to improve this could include increasing staff awareness of the target, quicker preparation of discharge medication and recognition of high-risk groups/ wards.
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