Title: Post-Operative Outpatient Mastectomy Patient Survey
Lisa A. Ross, M.D., Deborah M. Axelrod, M.D., Beth M. Siegel, M.D., Stephanie F. Bernik, M.D., George G. Neuman, M.D., David J. Friedman, M.D., Barry Goldenberg, M.D., Jimmy Moe, M.D., James I. Cyriac, M.D., Donald M. Mathews, M.D.
St. Vincents Hospital Manhattan, Comprehensive Cancer Center, New York, NY

Introduction: The practice of outpatient mastectomy remains controversial. To improve our understanding of the patient’s experience, we conducted a post-operative, written survey. Through this survey, we attempted to answer a number of questions including, the motivation for having the procedure done on an ambulatory basis and to identify areas of peri-operative concern. Of particular importance was the time to become comfortable with management of the drain as each patient had at least one drain and this required the most teaching. We hoped that the information might improve our preoperative education process and potentially increase patient satisfaction.
Methods: Between October 1999 and September 2004, 88 outpatient mastectomies were performed on 86 patients at our institution (two patients returned for a prophylactic mastectomy). The age range was 26-78 and all patients were ASA I-III. Following IRB approval, a twenty-question anonymous survey was sent to each patient. Five questions addressed the patient’s motivation for having the procedure performed as an out-patient, preoperative concerns and post-operative management.
Results: The response rate was 58.1%.
Motivation: 72% of the respondents said they wanted to return home to their family and not stay overnight, 40% wanted a more intimate facility and 36% claimed after considering the options, there were more pros than cons. Preoperative concerns: drain management 30%, pain control 22%, and 40% had no concerns. Postoperatively, a majority (82%) said there were no “issues” that could have been better managed with an overnight hospital stay, while 10% experienced nausea and vomiting beyond what they expected and 6%
had more difficulty with the drain than expected. When asked about the time required to become comfortable with drain management: 66% required one day or less, 11.4% required two days, 4.5% required seven days and 4.5% stated they were never comfortable managing the drain at home. Overall, 86% of our patients felt that having the mastectomy as an outpatient was the right decision for them. Of those surveyed, 10% believed they would have benefited from a visit from a nurse on the night of surgery.
Discussion: The data from this survey demonstrated that overall satisfaction with outpatient mastectomy was high. Preoperatively, patients were concerned about
drain management and pain control while postoperatively, pain control did not seem to be an issue. This information will be utilized to augment education about the procedure. It may be constructive to arrange for visiting nurse service for those patients who exhibit the greatest concerns about the drain management during the preoperative education process.

TOP

© SOCIETY FOR AMBULATORY ANESTHESIA
520 N. Northwest Highway Park Ridge, Illinois 60068-2573
Tel: (847) 825-5586 Fax: (847) 825-5658
E-mail: samba@asahq.org