[Ambulatory surgery, potential implementation for 17 interventions].

Abstract

Out-patient surgical practice, which allows the patient to leave the hospital a few hours after the intervention, is fairly recent in France and has not yet reached its full expansion. The out-patient surgery French Association (Association française de chirurgie ambulatoire-AFCA) proposes to pursue its development in twenty or so surgical acts. We present an overview of the 17 principle acts. We will then assess the possibilities, according to a method used in Quebec, of developing each of these surgical acts. The proportion of out-patient hospitalizations, varies greatly depending on the surgical act considered. Surgery for cataract is frequent (400,000 hospitalizations in 1999), but only one quarter of these acts are managed in an out-patient department. Conversely, the placing of trans-tympanic drains, which represents four-fold less hospitalizations, is performed in out-patient departments in nine cases out of ten. For the same surgical act, the rates of out-patient surgery vary from one establishment to the next: some have high rates, demonstrating the adaptation of their organization to out-patient surgery, others only operate in complete hospital settings, with more or less long hospitalization periods. Among the surgical acts considered, eye surgery, whether for cataract or strabismus, is that which appears to have the best potential for development, in view of a relatively low rate of out-patient surgery and a large proportion of hospitalization periods of one to two days.