摘要
目的观察日归模式在经腹腹膜前(transabdominal preperitoneal,TAPP)腹腔镜疝修补术中的应用效果。方法回顾性收集2022年7月至2023年6月期间于四川大学华西天府医院日间服务中心行TAPP腹腔镜疝修补术患者。所有患者按照日归计划收入,当日入院,当日手术,当日归宅,即不在医院过夜的患者(四川大学华西天府医院现在日归计划基本在8∶00-20∶00,最迟21∶00出院)划归为日归组;但是一些特殊病例(由于病情需要延期或因其他原因譬如由于全身麻醉患者术后观察时间不足2~4 h,出于安全考虑建议当日21∶00以后出院的患者或患者强烈要求过夜住院且住院时间最长不超过24 h的患者)划归于非日归组。分析日归组和非日归组患者在性别、年龄、婚姻状况、身体质量指数、疝类型、手术侧、家庭住址、术中出血量、手术时间、住院总费用、出院时的疼痛评分、术后30 d内非计划再就诊率、出院后第28天时的满意度等方面的差异。结果本研究共收集到行TAPP腹腔镜疝修补术患者167例,其中日归组97例、非日归组70例。日归组和非日归组患者在性别、年龄、婚姻状况、身体质量指数、疝类型、手术侧、术中出血量、手术时间及住院总费用方面比较差异均无统计学意义(P>0.05),但发现非日归组患者的家庭住址在成都市外者占比较日归组高(P<0.001),非日归组患者出院时的疼痛评分高于日归组(P=0.042),所有患者出院后第28天时的满意度为100%,术后30 d内非计划再就诊率为3.6%(6/167),虽然日归组略高于非日归组,但经Fisher精确检验比较差异无统计学意义[4.1%(4/97)比2.9%(2/70),P=0.226]。结论从本组资料分析结果看,TAPP腹腔镜疝修补术在日归手术模式下开展是安全的,可进一步缩短患者住院时间。
Objective To observe the effect of transabdominal preperitoneal(TAPP)laparoscopic hernia repair by same-day surgery mode for patients with inguinal hernia.Methods The patients who underwent TAPP laparoscopic hernia repair were retrospectively collected in the Day Surgery Center of West China Tianfu Hospital from July 2022 to June 2023.All patients in this study were admitted according to the same-day surgery plan,and those who were admitted to the hospital on the same day,operated on the same day,and returned to their homes on the same day,i.e.,those who did not stay in the hospital overnight(the same-day surgery plan of the West China Tianfu Hospital of Sichuan University is now basically in the range of 8:00-20:00,and the latest discharge is at 21:00)were classified as the same-day surgery group;however,the patients whose special cases needed to be postponed due to the condition of their illnesses,or those who were discharged from the hospital after 21:00 due to safety considerations because of other reasons such as postoperative observation of patients with general anesthesia for a period ofless than 2-4 h,or those who had a strong desire to be admitted to the hospital overnight,and whose hospital stay was not more than 24 h,were classified as the nonsame-day surgery group.The age,gender,marital status,body mass index,hernia type,surgical site,home address,intraoperative bleeding,operative time,total hospitalization cost,pain score at discharge,unplanned revisit rate within 3o d after surgery,discharge satisfaction were compared between the patients of two groups.Results A total of 167 patients underwent TAPP laparoscopic hernia repair were enrolled in this study,including 97 in the same-day surgery group and 70 in the non-same-day surgery group.There were no statistically significant differences in the age,gender,marital status,body mass index,hernia type,surgical site,intraoperative bleeding,operative time,and total hospitalization cost between the two groups(P>0.05).However,it was found that the patients in
作者
骆雪
孙义元
马东扬
马洪升
赵晓燕
宋应寒
LUO Xue;SUN Yiyuan;MA Dongyang;MA Hongshengl;ZHAO Xiaoyan;SONG Yinghan(Day Surgery Center,West China Tianfu Hospital,Sichuan University,Chengdu 610213,P.R.China;Day Surgery Center,General Practice Medical Center,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Division of Gastrointestinal Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,P.R.China;Department of Gastrointestinal Hernia,West China Tianfu Hospital,Sichuan University,Chengdu 610213,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2024年第6期706-711,共6页
Chinese Journal of Bases and Clinics In General Surgery
基金
四川省科技计划项目重点研发项目(项目编号:2022YFS0230)。
关键词
腹股沟疝
日归手术
经腹腹膜前疝修补术
腹腔镜
安全性
inguinal hernia
same-day surgery
transabdominal preperitoneal hernia repair
laparoscope
safety
