Outpatient Thoracoscopic Mediastinal Biopsy: A Safe and Cost-Effective Approach.
Journal
The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R
Informations de publication
Date de publication:
11 2020
11 2020
Historique:
received:
18
12
2019
revised:
02
04
2020
accepted:
10
04
2020
pubmed:
7
6
2020
medline:
15
12
2020
entrez:
7
6
2020
Statut:
ppublish
Résumé
Most mediastinal biopsy patients are managed with an overnight inpatient stay and chest drainage. We sought to determine the safety, accuracy, and cost of outpatient thoracoscopic mediastinal biopsy by reviewing operative techniques, perioperative outcomes, and admission charges for this procedure. This single-institution retrospective study reviewed all patients who underwent elective thoracoscopic mediastinal biopsy between 2012 and 2017. Patients were assigned to outpatient or inpatient management preoperatively based on surgeon judgment and preference. The procedures were performed in the supine or lateral decubitus position using ports only. Patients discharged on postoperative day 0 (outpatient) were compared with those discharged on postoperative day 1 or greater (inpatient). A total of 46 patients were included. Thirty-one patients were outpatients, and 15 were admitted. The outpatient cohort was younger than the inpatient group (48 years of age vs 66 years of age; P = .001). There was no statistically significant difference in other baseline characteristics. The operative time was longer (P = .001) and the total charges were higher (P = .003) in the inpatient cohort. One patient in each group had a nondiagnostic procedure. One patient in the outpatient group returned to the emergency department for pain but was discharged. There were no complications. Outpatient thoracoscopic mediastinal biopsy is a safe and effective procedure that has lower charges compared with inpatient management and should be considered for patients undergoing this procedure.
Sections du résumé
BACKGROUND
Most mediastinal biopsy patients are managed with an overnight inpatient stay and chest drainage. We sought to determine the safety, accuracy, and cost of outpatient thoracoscopic mediastinal biopsy by reviewing operative techniques, perioperative outcomes, and admission charges for this procedure.
METHODS
This single-institution retrospective study reviewed all patients who underwent elective thoracoscopic mediastinal biopsy between 2012 and 2017. Patients were assigned to outpatient or inpatient management preoperatively based on surgeon judgment and preference. The procedures were performed in the supine or lateral decubitus position using ports only. Patients discharged on postoperative day 0 (outpatient) were compared with those discharged on postoperative day 1 or greater (inpatient).
RESULTS
A total of 46 patients were included. Thirty-one patients were outpatients, and 15 were admitted. The outpatient cohort was younger than the inpatient group (48 years of age vs 66 years of age; P = .001). There was no statistically significant difference in other baseline characteristics. The operative time was longer (P = .001) and the total charges were higher (P = .003) in the inpatient cohort. One patient in each group had a nondiagnostic procedure. One patient in the outpatient group returned to the emergency department for pain but was discharged. There were no complications.
CONCLUSIONS
Outpatient thoracoscopic mediastinal biopsy is a safe and effective procedure that has lower charges compared with inpatient management and should be considered for patients undergoing this procedure.
Identifiants
pubmed: 32504602
pii: S0003-4975(20)30792-X
doi: 10.1016/j.athoracsur.2020.04.056
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1726-1729Informations de copyright
Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.