腹腔镜妇科肿瘤手术患者当日出院的可行性。

IF 2.2 Q2 OBSTETRICS & GYNECOLOGY

Journal of obstetrics and gynaecology Canada Pub Date : 2025-07-02 DOI:10.1016/j.jogc.2025.103025

Mandy Litt MD , Jack Thorburn MD , Joannie Neveu MD

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引用次数: 0

摘要

目的：评价复杂腹腔镜妇科肿瘤手术患者当日出院（SDD）的安全性和可行性。方法：回顾性分析2019年10月至2023年7月接受子宫内膜癌、输卵管癌或宫颈癌手术分期、子宫内膜增生或盆腔肿块治疗的患者。手术包括腹腔镜全子宫切除术。完成SDD的患者与需要住院的患者进行比较。数据收集包括临床、人口统计学和手术后6周的围手术期变量。进行单因素和多因素分析。结果：纳入152例患者。在多变量分析中，显著预测入院的变量为年龄≥61岁(优势比[OR]， 0.256；95%置信区间[CI]， 0.102-0.642；P = 0.004), bmi≥30-34.9 (or, 0.291；95% ci, 0.094-0.905), bmi≥35 (or, 0.207；95% ci, 0.075-0.569；P = 0.002)，手术时间≥181分钟(OR, 0.143；95% ci, 0.057-0.361；P < 0.001)，手术开始时间在下午2:00或更晚(or, 0.135；95% ci 0.036-0.503；P = 0.003)。术后96小时患者位置。入院患者的平均住院时间为1.09天。结论：SDD对患者是安全可行的。术后很少有并发症、再入院或计划外的患者接触。它的成功可以通过使用预测变量改进患者选择来提高。

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Feasibility of Same-Day Discharge in Patients Undergoing Laparoscopic Gynaecologic Oncology Surgery

Objectives

To evaluate the safety and feasibility of same-day discharge (SDD) of oncology patients undergoing complex laparoscopic gynaecologic oncology surgery.

Methods

A retrospective review including patients from October 2019 to July 2023 undergoing surgical staging for endometrial, tubal, or cervical cancer, treatment for endometrial hyperplasia or pelvic masses. Surgeries included a total laparoscopic hysterectomy. Patients accomplishing SDD were compared with those requiring admission. Data collection included clinical, demographic, and perioperative variables up to 6 weeks after surgery. Univariate and multivariate analyses were conducted.

Results

A total of 152 patients were included. On multivariate analysis, variables that significantly predicted admission were age ≥61 (OR 0.256; 95% CI 0.102–0.642, P = 0.004), BMI ≥30–34.9 kg/m² (OR 0.291; 95% CI 0.094–0.905), BMI ≥35 kg/m² (OR 0.207; 95% CI 0.075–0.569, P = 0.002), operative time ≥181 minutes (OR 0.143; 95% CI 0.057–0.361, P < 0.001), and an operative start time after 2:00 PM or later (OR .135; 95% CI 0.036–0.503, P = 0.003). Patient’s location <1 hour away from the centre significantly increased the odds of SDD (OR 2.50; 95% CI 1.068–5.863, P = 0.035). Of 51 patients who accomplished SDD, there was a <4% failure rate, with those who were discharged requiring admission >96 hours postoperatively. The average length of stay was 1.09 days.

Conclusions

SDD is safe and feasible for patients. There are few complications, re-admissions, or unscheduled patient contacts postoperatively. Its success can be increased by refining patient selection using predictive variables.

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来源期刊

Journal of obstetrics and gynaecology Canada OBSTETRICS & GYNECOLOGY-

CiteScore

3.30

自引率

5.60%

发文量

302

审稿时长

32 days

期刊介绍： Journal of Obstetrics and Gynaecology Canada (JOGC) is Canada"s peer-reviewed journal of obstetrics, gynaecology, and women"s health. Each monthly issue contains original research articles, reviews, case reports, commentaries, and editorials on all aspects of reproductive health. JOGC is the original publication source of evidence-based clinical guidelines, committee opinions, and policy statements that derive from standing or ad hoc committees of the Society of Obstetricians and Gynaecologists of Canada. JOGC is included in the National Library of Medicine"s MEDLINE database, and abstracts from JOGC are accessible on PubMed.