Factors influencing length of stay after surgery for benign foregut disease

Dickinson, Karen J.; Taswell, James; Allen, Mark S.; Blackmon, Shanda H.; Nichols, Francis C.; Shen, Robert; Wigle, Dennis A.; Cassivi, Stephen D.

doi:10.1093/ejcts/ezv453

Cited by 13 publications

(9 citation statements)

References 19 publications

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“…Furthermore, we observed an approximately 40-minute decrease in both operation time and CO 2 pneumoperitoneum in the present study compared with our previous RCT [4]. Previous studies suggested operation time [26,32,37,38] and postoperative pain [28,38,39] as factors that influence LHSS. Thus, at least 3 modifiable factors exist at an institutional and/or individual surgeon level-postoperative pain, operative time, and OR exit time-that may potentially influence LHSS in very elderly patients after laparoscopic surgical treatment for genital prolapse.…”

Section: Discussionsupporting

confidence: 61%

“…In the present study as well as in our previous RCT [4], all patients were informed of their expected discharge on postoperative day 3. Social reasons requiring a longer hospital stay are more common in elderly patients [23,24,26,27,31]. Furthermore, studies have shown that older age can influence LHSS after surgery [26,31,32].…”

Section: Discussionmentioning

confidence: 99%

“…Social reasons requiring a longer hospital stay are more common in elderly patients [23,24,26,27,31]. Furthermore, studies have shown that older age can influence LHSS after surgery [26,31,32]. Nevertheless, in the present study, 77.3% (22 of 30) of the patients were discharged within 48 hours after surgery, whereas among the elderly patients aged ≥65 years in our previous RCT [4], only 25.0% (5 of 20) of the patients in the 12-mm Hg group and 23.5% (4 of 17) in the 8-mm Hg group were discharged within 48 hours (Supplemental Table 1).…”

Section: Discussionmentioning

confidence: 99%

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Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older

Matsuzaki

Bonnin

Fournet-Fayard

et al. 2021

Journal of Minimally Invasive Gynecology

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Study Objective: Previous clinical trials for laparoscopic surgery have included few elderly patients aged ≥75 years. We aimed to evaluate the quality of postoperative recovery after laparoscopic surgery using low intraperitoneal pressure (IPP) (6 mm Hg) and warmed, humidified carbon dioxide gas for genital prolapse in elderly patients aged ≥75 years. Design: Prospective consecutive case series. Setting: University hospital. Patients: Consecutive patients (n = 30) aged ≥75 years planning to undergo laparoscopic surgery for genital prolapse by the same surgeon were recruited from October 2016 through December 2019. Interventions: Laparoscopic promontofixation for the treatment of genital prolapse was performed using low IPP and warmed, humidified carbon dioxide gas. When a promontory could not be easily identified, laparoscopic pectopexy was alternatively performed. Measurements and Main Results: The primary outcome was the Quality of Recovery−40 (QoR-40) score at 24 hours postoperatively. The secondary outcomes were postoperative pain using a 100-mm visual analog scale and the length of hospital stay after surgery (LHSS). For the global QoR-40 score and for 4 dimensions of the QoR-40, "emotional state," "physical comfort," "psychologic support," and "pain," no differences were observed between the baseline score and the score at 24 hours. The score for the "physical independence" dimension at 24 hours was significantly lower than the baseline score (p <.001). No patient had visual analog scale pain scores >30 out of 100 at 12 hours or later. LHSS was <48 hours in 22 patients (73.3%) and <72 hours in 8 patients (26.7%). Multivariable analysis showed that the odds of an LHSS >48 hours were more than 8 times higher in patients who were discharged from the operating room in the afternoon compared with those with a morning discharge. Conclusion:The use of a low IPP is feasible, safe, and has clinical benefits for elderly patients aged ≥75 years who undergo laparoscopic surgery for genital prolapse.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older

Matsuzaki

Bonnin

Fournet-Fayard

et al. 2021

Journal of Minimally Invasive Gynecology

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“…Yeh et al reported that diabetes increased length of hospital stay and 30-day postoperative mortality [ 40 ]. An earlier study suggests that age, surgery type, and laparoscopic or open surgery are predictive factors in increased postoperative hospitalization duration [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study

Tan

Wang

et al. 2023

BMC Anesthesiol

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Background Sugammadex is a newer medication used for rapid and reliable reversal of neuromuscular blockade. This study evaluated whether sugammadex could reduce the length of postoperative hospital stay in patients undergoing abdominal surgery. Methods This single center retrospective cohort study included patients who underwent major abdominal surgery between January 2015 and October 2019. Patients were randomized according to reversal with sugammadex or spontaneous recovery. The primary outcome was length of postoperative hospital stay. The secondary outcomes were length of post-anesthetic care unit (PACU) stay, postoperative ambulation time, time-to-first-defecation, and incidence of pulmonary complications. After 1:1 propensity score matching, univariate and multiple linear regression analyses estimated the differences in outcomes. Results Of the 1614 patients, 517 received sugammadex and 645 spontaneously recovered. After adjusting for potential confounders, non-linear relationship was detected between administration of sugammadex and the length of postoperative hospital stay (β = 0.29 95% confidence interval {CI}: [− 1.13, − 0.54], P = 0.4912). However, it was associated with shorter PACU stay (β = − 20.30 95% CI: [− 24.48, − 17.11], P < 0.0001), shorter time to postoperative ambulation movement (β = − 0.43 95% CI: [− 0.62, − 0.23], P < 0.0001), and reduced time-to-first-defecation (β = − 2.25 95% CI: [− 0.45, − 0.05], P = 0.0129), when compared to the spontaneously recovered group. The incidence of pneumonia in the sugammadex group was significantly lower than that in the spontaneously recovered group (18.6% [44/237] vs. 39.2% [93/237] P < 0.05). Conclusions Neuromuscular blockade reversal with sugammadex after abdominal surgery demonstrated an excellent recovery profile and was associated with decreased risk of pneumonia, although it did not affect the length of postoperative hospital stay.

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“…Hospital hospitalization rates have been shown to be the most important direct cost predictor of patient, which accounts for 31-68% of hospitalization expenses [10,22]. In Yang et al's report [9], they analyzed the material costs, care costs and specific time associated with indwelling catheters in the NUC and UC groups in detail (including time to place the catheter, time to replace the drainage device, time to observe and care the patient and time to remove the catheter).…”

Section: Main Textmentioning

confidence: 99%

No drains in thoracic surgery with ERAS program

Shen

Che

2020

J Cardiothorac Surg

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Enhanced recovery after lobectomy surgery (ERAS) concept has been greatly developed between clinical implementation and minimally invasive surgery. In addition to the minimally invasive surgery, the management of the perioperative catheter has also attracted everyone's attention. Tubeless minimally invasive treatment includes no urinary catheter placement during the operation and no chest tube after the operation. Here, we summarized all the reports on no urinary catheterization and no chest tube in patients with thoracic surgery and the impact of postoperative length of stay (LOS) and postoperative complications. We find that avoiding chest drain and urinary catheter placement after the surgery appears to be safe and beneficial for patients.

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Factors influencing length of stay after surgery for benign foregut disease

Cited by 13 publications

References 19 publications

Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older

Effects of Low Intraperitoneal Pressure on Quality of Postoperative Recovery after Laparoscopic Surgery for Genital Prolapse in Elderly Patients Aged 75 Years or Older

Analysis of the association of sugammadex with the length of hospital stay in patients undergoing abdominal surgery: a retrospective study

No drains in thoracic surgery with ERAS program

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