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

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.