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Wiley InterScience | ||||
 Australian and New Zealand Journal of SurgeryVolume 69 Issue 12, Pages 841 - 843 Published Online: 6 Apr 2002 Blackwell Science Asia Pty. Ltd.
Abstract | References | Full Text: HTML, PDF (Size: 26K) | Related Articles | Citation Tracking  ORIGINAL ARTICLE A PROSPECTIVE RANDOMIZED TRIAL OF DAY-STAY ONLY VERSUS OVERNIGHT-STAY LAPAROSCOPIC CHOLECYSTECTOMY Copyright 1998 Blackwell Science Asia Pty. Ltd. KEYWORDS ambulatory surgery • cost-effectiveness • laparoscopic cholecystectomy ABSTRACTBackground: 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.
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