Articles: ambulatory-surgical-procedures-methods.
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Multicenter Study Comparative Study
Comparison of 2-level cervical disc replacement vs. 2-level anterior cervical discectomy and fusion in the outpatient setting.
Retrospective cohort study. ⋯ To our knowledge, this is the largest multicenter study examining the safety of two-level outpatient CDR procedures. Outpatient two-level CDR was associated with similarly safe outcomes when compared to inpatient two-level CDR and outpatient two-level ACDF. This suggests that two-level CDR can be performed safely in the outpatient setting.Level of Evidence: 3.
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Randomized Controlled Trial Multicenter Study Comparative Study
Pain management after ambulatory surgery: a prospective, multicenter, randomized, double-blinded parallel controlled trial comparing nalbuphine and tramadol.
Postoperative pain in ambulatory surgery is a multifactorial issue affecting patient satisfaction, time of discharge, and rehospitalization. This study evaluated the efficacy and safety of nalbuphine for the treatment of postoperative pain after ambulatory surgery, relative to tramadol. ⋯ Nalbuphine can provide effective and safe pain relief in patients after ambulatory surgery.
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Multicenter Study
Robotic Approach to Outpatient Inguinal Hernia Repair.
Robotics offers improved ergonomics, visualization, instrument articulation, and tremor filtration. Disadvantages include startup cost and system breakdown. Surgeon education notwithstanding, we hypothesize that robotic inguinal hernia repair carries minimal advantages over the laparoscopic or open approach. ⋯ Robotic surgery has increased charges and is performed in sicker, higher-income patients. The open approach is more apt to be performed in black/Hispanic, self-pay patients, and for-profit hospitals. The role for robotic inguinal hernia repair is undefined.
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Advances in therapy · Jan 2020
Multicenter Study Clinical Trial Observational StudyFactors Determining the Choice of Spinal Versus General Anesthesia in Patients Undergoing Ambulatory Surgery: Results of a Multicenter Observational Study.
Available short-acting intrathecal anesthetic agents (chloroprocaine and prilocaine) offer an alternative to general anesthesia for short-duration surgical procedures, especially ambulatory surgeries. Factors determining the choice of anesthesia for short-duration procedures have not been previously identified. ⋯ Patient's choice, patient fear of the alternative technique, patient stress/anxiety, the expected ease of recovery, and the efficacy of the technique were identified as the main factors influencing patient choice of short-acting local anesthesia or general anesthesia. Spinal anesthesia with short-acting local anesthetics was preferred to general anesthesia in ambulatory surgeries and was associated with a high degree of patient satisfaction.
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To evaluate short-term outcomes of laparoscopic colectomy for selected consecutive patients in an ambulatory setting at two institutions. ⋯ This is the first case of consecutive patients undergoing ambulatory colectomy for malignant or benign disease. We demonstrated the feasibility, safety, and reproducibility of outpatient colectomy for selected patients. In our experience, 30% of patients scheduled for elective colectomy can be managed in an ambulatory setting.