Day case parathyroidectomy: is this the right way for the patients?
Parathyroid gland
day surgery
patient satisfaction
Journal
Gland surgery
ISSN: 2227-684X
Titre abrégé: Gland Surg
Pays: China (Republic : 1949- )
ID NLM: 101606638
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
entrez:
15
2
2020
pubmed:
15
2
2020
medline:
15
2
2020
Statut:
ppublish
Résumé
Minimally-invasive video-assisted parathyroidectomy (MIVAP) can be considered as the primary treatment of choice for single parathyroid adenoma. Often, this technique is performed in a day surgery setting and is associated with regional anaesthesia (RA). Many studies have already reported the feasibility and safety of MIVAP in day surgery. Here our focus has been on the patient's personal experience with these procedures through an assessment of their recovery at home. We conducted a prospective observational study in the University Hospital of Pisa Day Surgery Unit. Forty-eight patients were enrolled and divided by personal choice of anaesthesia technique: a regional anaesthesia group (RAg) and general anaesthesia group (GAg). Data were extracted from the medical records and three questionnaires: the first was self-compiled at discharge (Q1), while the second (Q2) and the third (Q3) were administered as telephone surveys. None of the patients in RAg reported pain longer than 1 day after discharge, whereas 15% of patients in GAg reported pain relief the third day after discharge (P=0.0065). Discharge in RAg was within 3 hours in 12.5% of patients, within 4 hours in 78.1%, and within 5 hours in 9.4%. Discharge in GAg was within 5 hours in 53.8% and in more than 5 hours in 46.1% (P=0.0027). Patients highly appreciated day-case parathyroidectomy. Furthermore, the association of RA with MIVAP leads to better results than those of general anaesthesia (GA) and MIVAP. Finally, we point out that it is fundamental that the physicians pay attention to what the patients consider important for them; that is, the personal meaning of the hospitalization.
Sections du résumé
BACKGROUND
BACKGROUND
Minimally-invasive video-assisted parathyroidectomy (MIVAP) can be considered as the primary treatment of choice for single parathyroid adenoma. Often, this technique is performed in a day surgery setting and is associated with regional anaesthesia (RA). Many studies have already reported the feasibility and safety of MIVAP in day surgery. Here our focus has been on the patient's personal experience with these procedures through an assessment of their recovery at home.
METHODS
METHODS
We conducted a prospective observational study in the University Hospital of Pisa Day Surgery Unit. Forty-eight patients were enrolled and divided by personal choice of anaesthesia technique: a regional anaesthesia group (RAg) and general anaesthesia group (GAg). Data were extracted from the medical records and three questionnaires: the first was self-compiled at discharge (Q1), while the second (Q2) and the third (Q3) were administered as telephone surveys.
RESULTS
RESULTS
None of the patients in RAg reported pain longer than 1 day after discharge, whereas 15% of patients in GAg reported pain relief the third day after discharge (P=0.0065). Discharge in RAg was within 3 hours in 12.5% of patients, within 4 hours in 78.1%, and within 5 hours in 9.4%. Discharge in GAg was within 5 hours in 53.8% and in more than 5 hours in 46.1% (P=0.0027).
CONCLUSIONS
CONCLUSIONS
Patients highly appreciated day-case parathyroidectomy. Furthermore, the association of RA with MIVAP leads to better results than those of general anaesthesia (GA) and MIVAP. Finally, we point out that it is fundamental that the physicians pay attention to what the patients consider important for them; that is, the personal meaning of the hospitalization.
Identifiants
pubmed: 32055493
doi: 10.21037/gs.2019.09.02
pii: gs-09-S1-S6
pmc: PMC6995900
doi:
Types de publication
Journal Article
Langues
eng
Pagination
S6-S13Informations de copyright
2020 Gland Surgery. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no conflicts of interest to declare.
Références
G Chir. 2016 Mar-Apr;37(2):61-7
pubmed: 27381690
Scand J Surg. 2015 Sep;104(3):196-9
pubmed: 25384910
Br J Surg. 2005 Jul;92(7):814-8
pubmed: 15931654
World J Surg. 2014 Nov;38(11):2825-30
pubmed: 24964756
J Endocrinol Invest. 2017 Sep;40(9):979-983
pubmed: 28374221
Anesthesiology. 2000 Aug;93(2):548-55
pubmed: 10910506
Endocr Pract. 2011 Mar-Apr;17 Suppl 1:75-82
pubmed: 21324817
Clin Endocrinol (Oxf). 2008 Apr;68(4):520-8
pubmed: 17973936
Hernia. 2013 Dec;17(6):745-8
pubmed: 23132638
J Laryngol Otol. 2012 Mar;126(3):221-7
pubmed: 22032618
Br J Surg. 2004 Jan;91(1):78-82
pubmed: 14716798
J Cancer. 2013 Jul 03;4(6):458-63
pubmed: 23901344
JAMA. 1963 Sep 21;185:914-9
pubmed: 14044222
Surgeon. 2012 Aug;10(4):202-5
pubmed: 22818277
Gerontologist. 1969 Autumn;9(3):179-86
pubmed: 5349366
Surgery. 2005 Oct;138(4):681-7; discussion 687-9
pubmed: 16269297
Otolaryngol Head Neck Surg. 2013 May;148(5):740-5
pubmed: 23401254
Ann Surg. 2002 May;235(5):665-70; discussion 670-2
pubmed: 11981212
Arch Dis Child. 2015 Oct;100(10):924-7
pubmed: 25897038
Gerontologist. 1970 Spring;10(1):20-30
pubmed: 5420677
Otolaryngol Head Neck Surg. 2016 May;154(5):789-96
pubmed: 27006296
Am J Surg. 2016 Oct;212(4):722-727
pubmed: 27659156