Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol
Background: The length of stay after Heller myotomy is 1–5 days. The aim was to report feasibility of the procedure as same day surgery (SDS). Methods: Three steps of Enhanced Recovery After Surgery protocol: preoperatively, clear liquid diet for 24 hours, in preoperative area: antiemetics as dermal...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-10-01
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| Series: | Surgery Open Science |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S258984501930017X |
| _version_ | 1818557932858507264 |
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| author | Chandni Kaushik Madison Milhoan Anshu Khanna Andre Miller Munish Chawla Charles C. Miller, III Farzaneh Banki |
| author_facet | Chandni Kaushik Madison Milhoan Anshu Khanna Andre Miller Munish Chawla Charles C. Miller, III Farzaneh Banki |
| author_sort | Chandni Kaushik |
| collection | DOAJ |
| description | Background: The length of stay after Heller myotomy is 1–5 days. The aim was to report feasibility of the procedure as same day surgery (SDS). Methods: Three steps of Enhanced Recovery After Surgery protocol: preoperatively, clear liquid diet for 24 hours, in preoperative area: antiemetics as dermal patch/IV form, 2: Intraoperatively, intubation in semi upright position, IV analgesics and antiemetics. 3: Postoperatively, clear liquid diet and discharge instructions. Patients were followed using a phone questionnaire. Values are median (interquartile range). Results: Fifty-seven patients, 32 M (56%)/25F (44%), age 48 (35–59). First 45 were inpatient with LOS of 1 day. Last 12 were planned as same day surgery, 1/12 was discharged on POD#2, 11/12 (92%) were performed as same day surgery. The duration of operation: 139.5 min (114–163) inpatient: vs 123 (107–139) same day surgery, P < .01. Questionnaires were obtained in 78% inpatient at 40 months (25.6–67) vs 82% same day surgery at 8 (4–12). All were satisfied with the operation with no difference between the 2 groups. Conclusion: Heller myotomy can be planned as same day surgery and performed successfully in majority of patients with a trained team and an Enhanced Recovery After Surgery protocol focused on prevention of nausea, and pain control in perioperative period. |
| first_indexed | 2024-12-14T00:06:11Z |
| format | Article |
| id | doaj.art-249f142fe5fc491ba7c5bce27959e91c |
| institution | Directory Open Access Journal |
| issn | 2589-8450 |
| language | English |
| last_indexed | 2024-12-14T00:06:11Z |
| publishDate | 2019-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj.art-249f142fe5fc491ba7c5bce27959e91c2022-12-21T23:26:01ZengElsevierSurgery Open Science2589-84502019-10-01126468Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocolChandni Kaushik0Madison Milhoan1Anshu Khanna2Andre Miller3Munish Chawla4Charles C. Miller, III5Farzaneh Banki6McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth)McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth)McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth)Memorial Hermann Southeast Esophageal Disease CenterMemorial Hermann Southeast Esophageal Disease CenterMcGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth)McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth); Memorial Hermann Southeast Esophageal Disease Center; Corresponding author at: Department of Surgery, McGovern Medical School at UTHealth, Director of Esophageal Disease Center, Memorial Hermann Southeast, 11914 Astoria Blvd. Suite 260, Houston, Texas 77089.Background: The length of stay after Heller myotomy is 1–5 days. The aim was to report feasibility of the procedure as same day surgery (SDS). Methods: Three steps of Enhanced Recovery After Surgery protocol: preoperatively, clear liquid diet for 24 hours, in preoperative area: antiemetics as dermal patch/IV form, 2: Intraoperatively, intubation in semi upright position, IV analgesics and antiemetics. 3: Postoperatively, clear liquid diet and discharge instructions. Patients were followed using a phone questionnaire. Values are median (interquartile range). Results: Fifty-seven patients, 32 M (56%)/25F (44%), age 48 (35–59). First 45 were inpatient with LOS of 1 day. Last 12 were planned as same day surgery, 1/12 was discharged on POD#2, 11/12 (92%) were performed as same day surgery. The duration of operation: 139.5 min (114–163) inpatient: vs 123 (107–139) same day surgery, P < .01. Questionnaires were obtained in 78% inpatient at 40 months (25.6–67) vs 82% same day surgery at 8 (4–12). All were satisfied with the operation with no difference between the 2 groups. Conclusion: Heller myotomy can be planned as same day surgery and performed successfully in majority of patients with a trained team and an Enhanced Recovery After Surgery protocol focused on prevention of nausea, and pain control in perioperative period.http://www.sciencedirect.com/science/article/pii/S258984501930017X |
| spellingShingle | Chandni Kaushik Madison Milhoan Anshu Khanna Andre Miller Munish Chawla Charles C. Miller, III Farzaneh Banki Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol Surgery Open Science |
| title | Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| title_full | Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| title_fullStr | Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| title_full_unstemmed | Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| title_short | Laparoscopic Heller myotomy and Dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| title_sort | laparoscopic heller myotomy and dor fundoplication in the same day surgery setting with a trained team and an enhanced recovery protocol |
| url | http://www.sciencedirect.com/science/article/pii/S258984501930017X |
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