Outcomes of endoscopic ethmoidectomy performed on a day-case basis: a prospective bi-centric study

Abstract

Evaluation of endoscopic ethmoidectomy performed as a day-case in terms of security, quality, and satisfaction of the patient. This prospective observatory bi-centric study over 1 year included 74 patients undergoing an ethmoidectomy respecting the eligibility criteria of ambulatory care. We recorded patients' demographic data, operative details, satisfaction, postoperative course, and follow-up results. Nasal symptoms were evaluated by SNOT-22 on preoperative appointment and postoperatively at D30. No non-absorbable nasal packing was used, eventually in the case of preoperative-bleeding absorbable gelatine packing. The postoperative follow-up took place at D1 by phone call and at D10 and D30 to assess complications, Visual Analogue Scale, and state of ethmoidal corridors by endoscopic exam. Patients benefited of bilateral ethmoidectomy in 82.4 % cases associated with septoplasty in 42 %. The majority (95 %) was discharged on the same day. Only one patient had bleeding at D0 and was kept in standard hospitalization, such as three other patients for medical or organizational reasons not related to surgery. At D1, 23 % described postoperative light bleeding but needed no revisit and pain was estimated at 1.3 (VAS). No readmission was observed, and no major complication was noted. SNOT-22 decreased successfully by 56 %, statistically related to postoperative treatment of corticosteroids and in the case of Samter triad. 97 % of patients were satisfied of the ambulatory care. These results suggest that within an experienced and dedicated day-case medical and paramedical team, ethmoidectomy can be safely performed on a day-case basis with high quality of taking care and satisfaction of patients.

Safety of day‐case endoscopic sinus surgery in England: An observational study using an administrative dataset

“…A French study focussing on patient reported outcomes for day‐case endoscopic ethmoidectomy reported no readmission and no major complications in their series of 74 patients. SNOT‐22 scores decreased on average by 56% post‐operatively, demonstrating good surgical outcomes in day‐case ESS 26 …”

“…SNOT-22 scores decreased on average by 56% post-operatively, demonstrating good surgical outcomes in day-case ESS. 26 One of the reasons often cited for the need to have an overnight observation following ESS, other than patient co-morbidities, is the risk of post-operative haemorrhage. 19 However, advances in ESS techniques have led to reduced morbidity associated with the procedure.…”

Potential Carbon Savings with Day-case Compared to Inpatient Transurethral Resection of Bladder Tumour Surgery in England: A Retrospective Observational Study Using Administrative Data

“…Further carbon savings could be made by reducing variation between hospitals in day-case delivery. Minimising hospital stays while maintaining levels of care and patient outcomes is one way to reduce carbon emissions, and there is evidence that day-case and outpatient surgery is as safe and effective as inpatient surgery for many procedures across a range of specialties [11] , [22] , [23] , [24] , [25] .…”

Safety of day-case endoscopic sinus surgery in England: An observational study using an administrative dataset

“…SNOT-22 scores decreased on average by 56% post-operatively, demonstrating good surgical outcomes in day-case ESS. 16 One of the reasons often cited for the need to have an overnight observation following ESS, other than patient co-morbidities, is the risk of post-operative haemorrhage. 12 However, advances in ESS techniques have led to reduced morbidity associated with the procedure.…”