Day surgery for gynaecological laparoscopy: Clinical results from an RCT

Abstract

This randomized controlled trial compared the clinical outcome from inpatient and ambulatory laparoscopy for benign gynaecological conditions. While 658 consecutive patients were considered for inclusion into the study, data from 26 inpatients and 40 ambulatory cases were analysed. Inpatient surgery was undertaken by more senior surgeons (p < 0.001), but complication rates were similar. For remedial surgery (but not diagnostic), ambulatory laparoscopy had shorter anaesthetic and operating times (p < 0.05) than inpatient surgery. Both inpatient and ambulatory patients reported significant improvements (p < 0.01) in immediate postoperative pain; similar proportions (64% and 74%, respectively) experienced postoperative nausea; 39% of inpatients and 58% of ambulatory patients reported problems after hospital discharge. Severity of pelvic pain was lower for both groups 1 month after operation in comparison to preoperative levels (inpatients: from 8.0 to 5.0, ambulatory: 6.0 to 3.0; on a 0–10 VAS). It was concluded that clinical and patient outcome was similar for the patients undergoing inpatient and ambulatory surgery for gynaecological laparoscopy.