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门诊主要选修 (HOME) 机器人结肠切除协议: ambulatory结肠切除的安全方法

Daman Bowman¹, Charles Proctor¹, Kristen Richards²

¹Department of General Surgery, Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, USA.

The American surgeon

|July 20, 2023

概括

门诊结肠切除是可行的,并安全的选择患者使用一种新的增强恢复途径. 这种方法可以减少医院负担并改善患者的治疗结果,没有观察到30天的再入院.

科学领域:

结肠直肠手术结肠直肠手术
外科手术的结果
增强的恢复途径

背景情况:

结肠直肠手术停留时间有所减少,但当天出院仍然不常见.
医院容量限制,加剧了COVID大流行,已经推迟了结肠切除.
有必要制定协议,使走动式结肠切除能够减少住院患者的负担.

研究的目的:

开发和评估在外科手术后增强恢复 (ERAS) 的协议路径,用于门诊结肠切除.
评估机器人部分切除术后在同一天出院的安全性和可行性.
为了减少与结直肠手术相关的整体医院住院患者负担.

主要方法:

一个新的ERAS协议 (HOME协议) 已被实施,以便在同一天下台.
11名患者接受了机器人部分切除术,并在手术当天出院.
患者根据健康状况 (ASA类1-2),低随访风险和家庭支持,每天远程监测3天和2周的临床随访来选择患者.

主要成果:

在同一天出院的11名患者中,在术后30天内没有再入院或并发症发生.
一名患者返回急诊室治疗疼痛,但没有入院.
机器人程序的平均操作时间为132.1分钟.

结论:

一个新的ERAS协议证明了门诊部分切除术的可行性和安全性.
这种方法适用于高度选择的患者子集.
对特定的结直肠外科手术患者来说,protocolized同日排泄可能是一个安全的选择.

关键词:

这是一种门诊外科手术.切除术 (colectomy) 是一个切除术.结肠直肠外科手术是什么加强手术后的康复,改善手术后的恢复.机器人手术是机器人手术的一种方式.同一天的放电.

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