Outpatient surgical unit: critical review after the first year of operation.

Introduction: Outpatient surgery has been quickly accepted by many hospitals, showing a lot of advantages, both in the quality of health care and also in hospital management. Following this trend, our Hospital started operating an Outpatient Surgical Unit in May 1997. Objectives: Once we had reached our 'cruising speed', we thought it wise to make a critical review of our experience. Material and methods: We have reviewed 331 patients who underwent surgery during the first year of operation, with special attention to the acceptance of this type of surgery by the population in general, and to the changes in pre-operative and post-operative protocols that this process has caused. Results: The rate of admission was 3.02%, and all of them occurred after 24 h. We found 57 minor complications (spotty dressing, mild inflammatory signs) on the first day assessment, but only 16 patients had refered complications. 91.5% of the questionnaires sent back by the patients qualify the experience as good or excellent. Conclusions: Outpatient Surgery is a good solution for many surgical pathologies, as it is well accepted by the general population. Inclusion and exclusion parameters regarding age, architectural obstacles and post-operative care can become selectively more lax.

[Spermatic cord lipoma]. / Lipoma de cordón espermático.

In spite of being the most frequent tumour in this location, together with adenomatoid tumours, the spermatic cord lipoma is a very rare entity (30-35% each). The etiology is unknown but linked to a constitutional factors, obesity, an its presentation is more frequent in the fifth or sixth decade of life. It progresses always as an asymptomatic tumour, usually unilateral, showing a swift growth to masses larger than 10 cm. Diagnosis is reached by ultrasound and CAT when doubtful, and the histology is confirmed during scrotomy. Tumour resection is the choice treatment. In the case reported here there had been two earlier resections, so relapses and pseudo-relapses should be taken into account. Although rare, a few cases of lipoma degeneration to liposarcoma have been reported.

[Parameatal cysts of the penis]. / Quistes parameatales del pene.

Parameatal cysts of the penis are highly infrequent, benign cysts of varied sizes usually unilateral. Contribution of two cases of parameatal cysts of the penis, one and epidermoid inclusion, allegedly post hypospadias surgery, while the other one is similar to the middle raphe cysts and appears to derive from the endodermal debris following a defective closure of the urogenital folds. Treatment is by surgical excision; simple aspiration or marsupialization may result in relapse and unsatisfactory cosmetic results.