Safety and Efficiency Outcomes of Ambulatory Gynaecologic Procedures in Canadian Surgical Centres Adopting a Common Model

OBJECTIVE:The current study aims to compare safety and efficiency outcomes of ambulatory gynaecological procedures performed under conscious sedation and/or local anaesthetic at two Canadian institutions. METHODS:A retrospective cohort study was completed over 1-year on patients presenting to the ambulatory care centres at two Canadian institutions that shared a common care model. Outcomes of interest were lead time (registration to discharge), procedural time, and intraoperative complications. Surgical data was derived from a retrospective chart review and outcomes were compared using the independent t-test and one-way ANOVA. RESULTS:A total of 1495 and 1098 patients presented to the two sites. The average age of patients was 35.5 ± 12.3 years and 41.7 ± 10.2 years. The most commonly performed procedures were dilatation and curettages at the first centre and operative hysteroscopies at the second centre. Average lead times were similar: 170.3 ± 35.8 minutes and 171.6 ± 45.4 minutes (p = 0.45). There was a significant difference in mean procedural time being 9.8 ± 5.5 minutes and 17.0 ± 10.0 minutes (p < 0.001). The rate of minor intraoperative complications was 3.8% and 6.6% (p = 0.002); whereas the rate of major complications was 2.7% and 3.3% (p = 0.43). CONCLUSION:In Canada, the majority of gynaecological procedures are performed under general anesthesia. By comparing outcomes at two separate Canadian centres, we demonstrated the reproducibility of a common ambulatory model for minor gynaecological procedures, supporting the implementation of similar care models across Canada.