“真正的一天”腹腔镜胆囊切除术在高容量专科单位和因素的审查,导致意外过夜。

IF 1.3 Q3 SURGERY
Minimally Invasive Surgery Pub Date : 2018-07-24 eCollection Date: 2018-01-01 DOI:10.1155/2018/1260358
A Solodkyy, A R Hakeem, N Oswald, F Di Franco, S Gergely, A M Harris
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引用次数: 14

摘要

腹腔镜胆囊切除术(LC)是治疗胆结石的金标准。英国日间手术协会建议至少60%的LCs作为日间手术进行。本研究的目的是评估我们的真实日病例LCs率,并回顾防止当日出院的因素。方法:前瞻性收集某地区综合医院32个月以上所有择期lc的资料。结果:500例患者在此期间接受了LC;438例(88.2%)患者计划日间住院,59例(11.8%)患者计划夜间住院。在计划当天出院的病例中,75.8% (n=332)当天出院,106例(24.2%)出现意外过夜。BMI >35和ASA3计划日病例患者多数顺利出院。漏孔插入、作业时间长、采油时间晚是造成UOS的主要原因。与日间病例相比,这一组的并发症更多。结论:该单位的“真实日病例”率高达75.8%。高BMI和ASA3不应成为日间手术的绝对禁忌症。大多数意外过夜是不可避免的,但可以通过患者选择、严格的术前评估、手术安排和减少不必要的引管来减少。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
'True Day Case' Laparoscopic Cholecystectomy in a High-Volume Specialist Unit and Review of Factors Contributing to Unexpected Overnight Stay.

Introduction: Laparoscopic cholecystectomy (LC) is the gold standard treatment for gallstones. British Association of Day Case Surgery recommends at least 60% of LCs be performed as day cases. The aim of this study was to assess our rate of true day case LCs and review factors preventing same-day discharge.

Methods: We prospectively collected data of all elective LCs performed in a district general hospital over 32 months.

Results: 500 patients underwent LC during this period; 438 (88.2%) patients were planned day cases and 59 patients (11.8%) planned overnight stays. Of the planned day cases, 75.8% (n=332) were discharged on the same day and 106 (24.2%) had unexpected overnight stay (UOS). Most patients with BMI >35 and ASA3 planned day case patients were successfully discharged. Drain insertion, longer operations, and late recovery departure were the main reasons for UOS. There were more complications in this group compared to day cases.

Conclusions: This unit has a high 'true day case' rate of 75.8%. High BMI and ASA3 should not be absolute contraindications to day case surgery. The majority of unexpected overnight stays are unavoidable but may be reduced by patient selection, stringent preoperative assessment, operation scheduling, and reduction in unnecessary drain insertion.

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CiteScore
3.00
自引率
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审稿时长
16 weeks
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