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在COVID大流行期间执行泌尿器科住院手术作为同一天的手术 一个回顾性可行性研究研究
Nicolas Siron1, Anis Assad1, Mona Ouirzanne1
1Division of Urology, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada.
概括
对于前列腺激光取核 (LEP),机器人辅助激进前列腺切除术 (RARP) 和穿皮瘤切除术 (PCNL) 的同一天出院对于某些患者来说是安全的和可行的. 这种方法可以减少住院治疗,而不会增加并发症或再入院率.
科学领域:
- 泌尿外科手术的结果
- 最少侵入性的外科手术程序.
- 医疗保健资源管理 医疗保健资源管理
背景情况:
- 随着COVID-19大流行,选择性泌尿外科手术的医生转向当天出院.
- 像LEP,RARP和PCNL这样的最小侵入性手术适用于门诊机构.
- 目标是减少住院治疗和节约医疗保健资源.
研究的目的:
- 追溯评估同一天放出LEP,RARP和PCNL的临床结果和安全性.
- 比较同日出院程序与传统的住院治疗程序.
- 评估并发症的发生率,急诊室的访问和再入院情况.
主要方法:
- 在2020年5月至2022年3月期间,对413名接受LEP,RARP或PCNL的患者进行了回顾性分析.
- 患者分为计划在同一天出院或住院患者组.
- 同一天失败,术后并发症和30天再入院率的比较.
主要成果:
- 在77.9% (LEP),73.9% (RARP) 和71.1% (PCNL) 符合条件的患者中成功实现了当天出院.
- 住院LEP患者的术后并发症比同日LEP患者高 (23.1%对比8.7%).
- 与同一天的RARP相比,住院RARP显示了30天ED访问的增加 (17.4%与4.1%相比);PCNL显示没有显著差异.
结论:
- 对于LEP,RARP和PCNL,当天出院是安全的,并且在精选的患者群体中是可行的.
- 同一天手术的并发症率是可以接受的.
- 建议通过更大规模的前性试验进行进一步验证,比较当天和住院治疗方法.
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