Septal and turbinate surgery: is overnight essential?

INTRODUCTION: The performance of septoplasty and turbinate surgery in an outpatient basis is an increasingly established practice, although is still a controversial topic.

METHODS: Retrospective analysis of 227 patients who underwent septoplasty ± inferior and/or middle turbinoplasty. Demographic, clinical, surgical, and anesthetic data were collected. Our primary outcomes were rates of perioperative complications, prolongation of hospital stay (PHS), unexpected hospital revisits (UHR), or readmissions within 30 days of surgery.

RESULTS: The UHR rate was 4.8 and 6.6% in the first 48 h and 30 postoperative days, respectively. The main reasons were nasal obstruction, self-limited epistaxis, and gastrointestinal intolerance to the prescribed antibiotic. Four patients required PHS due to nausea or vomiting and asthenia. There were no intraoperative complications, readmissions to the operative room, or hospital readmissions after discharge. The addiction of turbinate procedures was not associated with higher risk of complications. Patients with PHS were younger than those discharged as scheduled. There was no association between complications and comorbidities, gender, ASA classification, revision surgery, surgeon's grading, technique of inferior turbinoplasty, type of nasal packing, duration of anesthesia, and operative time.

CONCLUSION: The UHR rate of septoplasty performed at our unit is above that recommended for ambulatory procedures, but is within the range previously published and no major complications were seen. Septoplasty and turbinate surgery, including middle turbinate surgery, have a great potential to be undertaken as a day-case procedure, being patient selection the cornerstone of safe and efficient perioperative care.