Unplanned re-hospitalizations in proctology. An update

IF 2 4区医学 Q2 SURGERY

Journal of Visceral Surgery Pub Date : 2025-08-01 DOI:10.1016/j.jviscsurg.2025.07.006

Nadia Fathallah , Mathilde Aubert , Diane Mege

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引用次数: 0

Abstract

Proctological surgery is widely practiced in France, with over 100,000 procedures recorded in 2022. More than half of patients are treated as outpatients. Re-admissions or conversion from outpatient surgery to in-patient status are not uncommon and can occur in up to 18% of cases. The main reasons for early readmission are pain, acute urinary retention, bleeding, constipation, infection, anal fissure or hemorrhoid thrombosis. Later re-admissions can also occur due to anal stenosis, anal incontinence, and delayed healing. Prevention of complications is therefore essential to avoid these readmissions. This is based primarily on preoperative patient education regarding signs that may require emergency consultation, as well as on the identification of those patients at risk of bleeding, acute urinary retention, and infectious complications. Intraoperatively, adherence to the quality criteria of proctological surgery is essential, ranging from the choice of techniques to the control of hemostasis and certain technical details, such as respecting mucosal bridges in patients undergoing tripedicular hemorrhoidectomy, or chemical or surgical sphincterotomy in the case of fissurectomy. Pre- and postoperative therapeutic education is essential, as the systematic preparation of prescriptions preoperatively, and software-based patient support (e.g. text message reminders).

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直肠科意外再住院。一个更新。

直肠外科手术在法国广泛实施，2022年记录的手术超过10万例。一半以上的患者接受门诊治疗。再次入院或从门诊手术转为住院并不罕见，可发生高达18%的病例。早期再入院的主要原因是疼痛、急性尿潴留、出血、便秘、感染、肛裂或痔疮血栓形成。由于肛门狭窄、肛门失禁和延迟愈合，也可能发生再次入院。因此，预防并发症对于避免再入院至关重要。这主要是基于术前患者教育，了解可能需要紧急咨询的症状，以及识别有出血、急性尿潴留和感染性并发症风险的患者。术中，遵守直肠手术的质量标准是至关重要的，从技术的选择到止血的控制和某些技术细节，例如在进行三蒂痔切除术的患者中尊重粘膜桥，或在进行裂隙切除术的情况下进行化学或外科括约肌切开术。术前和术后的治疗教育是必不可少的，如术前处方的系统编制和基于软件的患者支持（如短信提醒）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Visceral Surgery SURGERY-

CiteScore

2.00

自引率

9.50%

发文量

108

审稿时长

>12 weeks

期刊介绍： The Journal of Visceral Surgery (JVS) is the online-only, English version of the French Journal de Chirurgie Viscérale. The journal focuses on clinical research and continuing education, and publishes original and review articles related to general surgery, as well as press reviews of recently published major international works. High-quality illustrations of surgical techniques, images and videos serve as support for clinical evaluation and practice optimization. JVS is indexed in the main international databases (including Medline) and is accessible worldwide through ScienceDirect and ClinicalKey.