Ambulatory ENT Surgery: Eight Years of Experience in A Tropical Environment

Main Article Content

Alexis Arnaud Wilfrid Comlan do Santos Zounon
Ulrich Bidossessi Vodouhe
Faridath Oke
Bignon Wannou
Lionelle Fanou
Wassi Adjibabi
Bernadette Yehouessi Vignikin

Abstract

Introduction


Ambulatory surgery allows minimizing the time spent in the hospital, which could reduce the transmission of nosocomial pathologies and the occupation of hospital resources and infrastructures. The objective of the study was to assess the ambulatory activity of the ENT department of Military Teaching Hospital of Cotonou since its creation.


Materials and methods


The study was monocentric retrospective covering an eight-year period from January 1, 2013, to January 1, 2021. It concerned all ENT surgeries where the patient was discharged on the same day, regardless of the type of anaesthesia used. A pre-established survey form was used to collect data from the medical records. The variables studied were socio-demographic factors, eligibility criteria, indications and conversion to inpatient mode.


Results


Over the study period half of the procedures performed (334 patients) corresponded to indications for outpatient surgery and then were included. Of these, 130 patients (38.9%) were rejected for various contraindications like geographical and financial accessibility and communication difficulties. A total of 204 patients (61.1%) underwent ENT ambulatory surgery. The sex ratio was 3 males to 5 females (0.6). Children under 15 years of age accounted for 43.7% (n=146). Tonsillectomy with or without adenoidectomy was the most frequent surgery accounting for half of the outpatient surgery cases. Pharyngeal surgery was the most performed: (126 patients) followed by cervico-facial surgery (44 patients). Reconversion to inpatient mode occurred in 39 patients (19.12%). No respiratory complications were noted. No deaths were recorded.


 


Conclusions 


Ambulatory care is a mode of management mainly used for pharyngeal surgery, in particular tonsillectomy and adenoidectomy in children. The main contraindications to patient eligibility were geographical and financial accessibility and communication difficulties. This activity would benefit from being better structured with specific staff and premises.

Article Details

How to Cite
1.
do Santos Zounon AAWC, Vodouhe UB, Oke F, Wannou B, Fanou L, Adjibabi W, Yehouessi Vignikin B. Ambulatory ENT Surgery: Eight Years of Experience in A Tropical Environment . BJOHNS [Internet]. 2022Dec.3 [cited 2024Dec.22];30(1):86-94. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/618
Section
Main article
Author Biographies

Alexis Arnaud Wilfrid Comlan do Santos Zounon, Faculty of Sciences and Health, University of Abomey-Calavi

Military Teaching Hospital

P.O.Box 517 Cotonou

Benin

Ulrich Bidossessi Vodouhe, Faculty of Sciences and Health, University of Abomey-Calavi

Faculty of Sciences and Health, University of Abomey-Calavi, 01 POB 188 Abomey-Calavi (BENIN)

Faridath Oke, Military Teaching Hospital P.O.Box 517 Cotonou

Military Teaching Hospital P.O.Box 517 Cotonou

Bignon Wannou, Military Teaching Hospital Cotonou P.O.Box 517 Cotonou

Military Teaching Hospital Cotonou P.O.Box 517 Cotonou

Lionelle Fanou, Military Teaching Hospital Cotonou P.O.Box 517 Cotonou

Military Teaching Hospital Cotonou P.O.Box 517 Cotonou

Wassi Adjibabi, Faculty of Sciences and Health, University of Abomey-Calavi

Faculty of Sciences and Health, University of Abomey-Calavi Cotonou, Republic of BENIN. 

Bernadette Yehouessi Vignikin, Faculty of Sciences and Health, University of Abomey-Calavi

Faculty of Sciences and Health, University of Abomey-Calavi Cotonou, Republic of BENIN

References

De Gabory L, Sowerby LJ, DelGaudio LM, et al. International survey and consensus (ICON) on ambulatory surgery in rhinology. Eur Ann Otorhinolaryngol Head Neck Dis. 2018; 135(1S):S49-S53. doi: 10.1016/j.anorl.2017.12.010

Michelet D. L’organisation de l’activité ambulatoire en Pédiatrie. Anesth Reanim. 2019; 5:4-9 (original article in French)

Al-Hussaini A, Walijee H, Owens D. The uptake of day-case septoplasty in England and Wales from 2000–2012; is there a relationship between day-case rates and waiting list times? Bulletin R Coll Surg Engl. 2016; 98:212-5

Luty AN, Tshipukane DN, Sokolo J, Kalombo T, Matanda Nzanza R. Indications d’amygdalectomie à Lubumbashi: profil clinique. Médecine d'Afrique Noire 2016 ; 6310 : 525-32 (original article in French)

Couloigner V. Chirurgie ambulatoire en ORL pédiatrique (enfants de moins de 18 ans). La lettre d’ORL et de Chirurgie Cervico-Faciale 2015; 342:8-12 (original article in French)

Mayhew D, Mendonca V, Murthy BVS. A review of ASA physical status – historical perspectives and modern developments. Anaesthesia 2019;74:373-9. doi: 10.1111/anae.14569

Bethoux JP, Gaucher S, Philippe H-J, Bouam S. Séparation des besoins de soins de ceux d'hébergement. Expérimentation d'un hôtel intrahospitalier à l'Hôtel-Dieu. Tech Hosp. 2015; 749:7-9 (original article in French)

Theissen A, Pujol N, Raspado O, Slim K. « Hôtels hospitaliers » : un pas de plus vers l'hospitalisation courte et la chirurgie ambulatoire. Presse Med. 2019; 48(3):219-22. https://doi.org/10.1016/j.lpm.2019.02.006 (original article in french)

Kériman M, Bastier P-L, Réville N. Feasibility study of bilateral radical ethmoidectomy in ambulatory surgery. Eur Ann Otorhinolaryngol Head Neck Dis. 2018; 135(6):377-82. doi: 10.1016/j.anorl.2018.08.002

Le Saché F, Maesani M, Franck L. Comment organiser la prise en charge des urgences chirurgicales en ambulatoire ? Le Praticien en anesthésie réanimation 2016 ; 20 :20-4 (original article in French)

Bartier S, Gharzouli I, Kiblut N, Bendimered H, et al. Amygdalectomie chez l’enfant et chez l’adulte: évolution des pratiques après ouverture d’une unité de chirurgie ambulatoire avec bloc opératoire dédié. Annales françaises d’Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale 2018; 135(5):295-300. https://doi.org/10.1016/j.aforl.2017.11.008 (original article in French)

Beaussier M, Sciard D, Farhat F. Chirurgie ambulatoire: quelle escorte pour la sortie et le domicile? Le Praticien en Anesthésie Réanimation 2020; 24(5): 275-8 (original article in French)

do Santos Zounon A, Balde D, Vodouhe UB, Adjibabi W, Vignikin-Yehouessi B. pathologies amygdaliennes et chirurgie de l’enfant. Rev Col Odonto-Stomatol Afr Chir Maxillo-fac. 2019; 26(4):28-33 (original article in French)

Rosen P, Bailey L, Manickavel S, Gentile C, Grayson J, Buczek E. Ambulatory Surgery vs Overnight Observation for Total Thyroidectomy: Cost Analysis and Outcomes. OTO Open 2021; 5(1):1-6. doi: 10.1177/2473974X21995104 http://oto-open.org

McLaughlin Eamon J, Brant Jason A, Bur Andres M, Fischer John P, Chen Jinbo, Cannady Steven B, Chalian Ara A, Newman Jason G. Safety of outpatient thyroidectomy: review of the American College of Surgeons National Surgical Quality Improvement Program. Laryngoscope 2018; 128(5):1249-54. doi: 10.1002/lary.26934

Yakhlef H., Marboeuf Y, Piquard A, Saint Marc O. Lobectomie thyroïdienne en ambulatoire ? Analyse rétrospective de faisabilité. Annales françaises d’ORL et de Pathologie Cervico-Faciale 2017; 134(4):220-3. doi: 10.1016/j.aforl.2016.07.017 (original article in French)

Diarra K, Konaté N, Sidibé Y, Sissoko T, et al. Surgery of the Goiter in the ENT Department of Chu Gabriel Toure: Problematic and Perspective. International Journal of Otolaryngology and Head & Neck Surgery 2019; 8:283-91. doi: 10.4236/ijohns.2019.86026

Sissoko M, Coulibaly M, Sacko O, Koumaré S, et al. Complications of Goitre Surgery in “A” Surgery at the Chu of Point G. Surgical Science 2021; 12 :46-52. doi:10.4236/ss.2021.123007

Benito DA, Pasick LJ, Bestourous D, Thakkar P, et al. Outpatient vs inpatient parotidectomy: Systematic review and meta-analysis. Head Neck 2021; 43(2): 668-78. doi: 10.1002/hed.26482

Bonnafous S, Hermann R, Zaouche S, Tringali S, Fieux M. Evolution et Sécurité de la prise en charge ambulatoire des chirurgies majeures de l’Oreille Moyenne. Annales Françaises d’Oto-Rhino-Laryngologie et Pathologies Cervico-Faciales 2021; 138(3):152-7. (original article in French)

Uziel A. La chirurgie ambulatoire en Otologie. Annales Françaises d’ORL et de Pathologie Cervico-Faciale 2017; 134(4):244-6. (Original article in French)

Belleudy S, Kérimian M, Legrenzi P, Alharbi A, de Gabory L. Évaluation de la qualité et de la sécurité de la chirurgie ambulatoire en rhinologie. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2021; 138(3):139-46. doi : https://doi.org/10.1016/j.aforl.2020.01.003 (Original article in French)

Rudolf Briner H, Leunig A, Schlegel C, Simmen D. Preoperative risk assessment for ambulatory sinonasal surgery. Eur Arch Otorhinolaryngol. 2021; 278(5):1455-61. doi: 10.1007/s00405-020-06435-4

de Gabory L, Serrano E, Lecanu JB, Ébbo D, Coudert F, Hanau M, Escabasse V. Recommandations de la SFORL sur la chirurgie ambulatoire en rhinologie. Annales Françaises d'ORL et de Pathologie Cervico-Faciale 2015; 132(1):32-8. doi: 10.1016/j.aforl.2014.10.003. (Original article in French)

Patel J, Boon M, Spiegel J, Huntley C. Safety of Outpatient Type 1 Thyroplasty. Ear Nose Throat J. 2021; 100(5_suppl): 608S-613S. doi:10.1177/0145561319894414

Junlapan, A, Sung, CK, Damrose, EJ. Type I thyroplasty: a safe outpatient procedure. Laryngoscope 2018; 129(7):1640-6. DOI:10.1002/lary.27686

Tolvi M, Lehtonen L, Tuominen-Salo H, Paavola M, Mattila K, Aaltonen LM. Overstay and Readmission in Ear, Nose, and Throat Day Surgery—Factors Affecting Postanesthesia Course. Ear Nose Throat Journal 2021; 100(7):477-82. doi: https://doi.org/10.1177/0145561319872165

Mortuaire G, Theis D, Fackeure R, Chevalier D, Gengler I. Évaluation de l’impact médico-économique de la chirurgie ambulatoire en rhinologie. Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale 2018; 135(1):13-8. doi : https://doi.org/10.1016/j.aforl.2017.04.005. (Original article in French)

Rouxel P, Tran L, Sitbon P, Martine V, Beloeil H, Comité Douleur et Anesthésie Locorégionale de la SFAR. Prise en charge de la douleur postopératoire : l’étude AlgoSFAR, un audit national de 3315 patients. Anesthésie & Réanimation 2021; 7(6):376-86. doi: https://doi.org/10.1016/j.anrea.2021.08.004. (Original article in french)

Hui-Hong L, Mei-Xue Z, Yuan-Ming W, Xing-Lan X, et al. The Incidence of and Risk Factors for Postoperative Fever after Cleft Repair Surgery in Children. J Pediatr Nurs. 2019; 45:e89-e94. doi: 10.1016/j.pedn.2019.01.009

Veiga-Gila L, Pueyob J, López-Olaondob L. Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment. Revista Española de Anestesiología y Reanimación 2017; 64(4):223-32. doi: https://doi.org/10.1016/j.redar.2016.10.001

Theissen Fuz F, Bouregba M, Autran M, Beaussier M. A ten-year analysis of the reasons for death following ambulatory surgery: Nine closed claims declared to the SHAM insurance. Anaesth Crit Care Pain Med. 2018; 37(5):447-51. doi: https://doi.org/10.1016/j.accpm.2018.03.001.