The scope and safety of short-stay surgery in the treatment of groin herniae and varicose veins a report on 705 cases

Abstract

Between 1948 and 1968 the number of surgical patients treated in England and Wales increased by 38·6 per cent. In 1968, 267, 300 more surgical patients were admitted to hospital than in 1948. During the same period of time the increase in the number of beds was less than 1 per cent. Faced with a steadily growing demand to treat patients suffering from cancer and other serious diseases it is difficult to find the beds and the operating time to treat patients with hernia and varicosa veins. Even so the operating performed on patients suffering from these two complaints amount to nearly one-third of all the operatons performed annually. There are 231 other operations in general surgery. As a result the average time patients with ruptures and variocse veins languish on hospital waiting lists is up to 2 years, and ofter for longer than that. At the present time in England and Wales the average time a patient stays in hospital after a herniorrhaphy or an operation for varicose veins is 10·5 days. This is an expensive waste of beds; 75 per cent of all patients can safely be sent home 48 hours after both these types of operatun. The number of patients who develop an acute postoperative comlication and cannote go home is only 5·4 per cent and the number who need readmission for a delayed complication is less than 1 per cent. Being discharged home 48 hours after having their hernia reparied or thier varicose veins operated on is popular both with the great majority of patients and also with their relatives. Moreover it is accepted by the general practitioners concerned. Proceeding in this way the time such patients have to wait for their operation is reduced to an average of 3–6 months. It is important to realize, however, that short-stay surgery will increase the total number of operations performed each year. They are additional operations and, as such, need extra theartre time and extra theatre staff, otherwise they cancnote be done. The present series of 705 cases could note have been operated on if an additional theartre and staff had not been provided.