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Chirurgie 16. Juni 2014

Is day surgery safe? A systematic literature review

Background: In many countries, day surgery is very common for some indications, especially in the USA, the UK and Scandinavia. In other countries—for example, Austria, Germany and Switzerland—day surgery is rare. This is due to financial disincentives, different systemic structures and shorter waiting lists for surgery.

Methods: We focused on the 15 most frequently delivered operations in Austria, from which we selected those that could be done in day surgery. For these 11 interventions, we made a systematic literature search in various databases.

Results: We researched 35 studies for data synthesis. On the basis of the summarised studies, we concluded that the following operations can be done safely (and effectively) in both day surgery and in inpatient setting in those patients who fulfil the eligibility criteria for day surgery: cataract surgery, arthroscopic operations of the knee, vein ligation (stripping), cholecystectomy (laparoscopic), adenoidectomy and repair of inguinal and femoral hernia. For the removal of implanted devices from bone, appendectomy, paracentesis, carpal tunnel decompression of median nerve and curettage, studies with a higher evidence level for robust assessment of the safety (and effectiveness) of day surgery are required, although these operations are already undertaken in a day surgery setting in many countries.

Conclusion: Day surgery can be defined as safe for selected interventions and patients. Day surgery requires increasing attention in countries such as Austria with a low level of day surgery, which is particularly evident when making international comparisons.

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