Key result
Day case ureteroscopy for stone treatment was associated with a significantly higher rate of same-day discharge (85.3% vs 17.6%) and shorter length of stay compared to inpatient care (P<0.001).
Why the study?
Day surgery is increasingly becoming the standard pathway for complex procedures, prompting an assessment of outcomes before and after relocating rigid and flexible ureteroscopy from an inpatient hospital setting to a day surgery unit.
Does ureteroscopy in a day case setting reduce length of stay compared to an inpatient setting in patients undergoing elective stone treatment?
Observational (n=136)
No
Does ureteroscopy in a day case setting reduce length of stay compared to an inpatient setting in patients undergoing elective stone treatment?
Relocating elective ureteroscopy for stone treatment to a day case setting significantly reduces length of stay without increasing complications or readmissions.
May support day-case ureteroscopy to shorten stays in stone treatment; hypothesis-generating and requires randomized confirmation before practice change.
Objective: Due to advances in surgical techniques and anaesthesia, day surgery is now becoming the standard care pathway for many complex procedures traditionally treated through inpatient pathways. Our aim was to study outcomes for patients undergoing rigid and flexible ureteroscopy before and after moving this service from a district general hospital to a day surgery unit. Methods: This was a retrospective observational study of 136 consecutive patients undergoing elective ureteroscopy for stone treatment. Half of the patients ( n=68, inpatient group) underwent treatment according to the standard inpatient pathway, while the other half underwent treatment following relocation of this service to a day case unit ( n=68, day case group). Outcomes were length of stay, readmission rate and complications. Results: In the inpatient group, 12 patients (17.6%) were discharged home the day of surgery (day 0), 42 patients (61.8%) stayed in hospital for one night. In the day case group, 58 patients (85.3%) were discharged on day 0, nine patients (13.2%) stayed for one night. Length of stay in the day case group was significantly shorter ( P<0.001). Rates of postoperative complications and readmissions were not significantly different. Conclusion: Day case ureteroscopy for stone treatment is feasible and safe. It is associated with a significantly reduced length of stay without an increase in postoperative complications or readmission.
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Kremel et al. (2020) conducted an observational in stone treatment (n=136). Day case ureteroscopy pathway vs. Standard inpatient pathway was evaluated on Discharge on day of surgery (p=<0.001). Day case ureteroscopy for stone treatment was associated with a significantly higher rate of same-day discharge (85.3% vs 17.6%) and shorter length of stay compared to inpatient care (P<0.001).
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