Same day discharge program promising in patients for Elective Benign Foregut Surgery

Researchers have found in a prospective cohort study that same-day discharge was feasible and safe for patients who underwent elective benign foregut surgery. Further Same-day home recovery program was feasible in three types of benign foregut surgical procedures -- fundoplication for gastroesophageal reflux disease, Heller myotomy for achalasia, and hiatal hernia repair, the researchers reported in JAMA Surgery.

For many major surgical operations, same-day home recovery is already the norm, and it has the potential to do the same for benign foregut treatments (eg, hiatal hernia repair, fundoplication, and Heller myotomy). Swee H. Teh and colleagues carried out this study in order to ascertain if SHR for patients having benign foregut surgery is practical, secure, and efficient.

From January 2019 through September 2021, 19 medical sites in a northern California integrated health care system participated in this prospective cohort research. Consecutive individuals getting elective benign foregut surgery were included as participants. The rate of SHR served as the main endpoint. The 7-day and 30-day rates of postoperative ER visits, hospital readmissions, and reoperations served as the secondary end goals.

The key findings of this study were:

1. Between January 2017 and September 2021, 1248 individuals received benign foregut surgery; 558 of them underwent the procedure before the SHR program's commencement and 690 after.

2. The patients were on average 60 years old, and 759 (59%) of them were female. In 2018, 64 of 558 patients (11.5%) had pre-implementation SHR; by 2021, that number had risen to 82 of 113 patients (72.6%).

3. In the post implementation period, there were no statistically significant changes between the SHR and non-SHR groups in the incidence of postoperative emergency department visits, hospital readmissions, reoperations, or 30-day mortality.

In conclusion, comprehensive patient education and complete interdisciplinary assistance are required due to the changes in perioperative treatment. An SHR program for benign foregut surgeries might enhance patient care and increase the efficiency of healthcare spending.

Reference: 

Teh, S. H., Schecter, S. C., Servais, E. B., Liu, K., Svahn, J., Yang, L., Goodstein, M., Parent, R., Chau, E., Chang, L., Zhou, M., Shiraga, S., & Knox, M. (2022). Same-Day Home Recovery for Benign Foregut Surgery. In JAMA Surgery. American Medical Association (AMA).https://doi.org/10.1001/jamasurg.2022.4245