在接受选择性腹腔镜胆囊切除术的大多数患者中,手术前入院是不必要的:一项队列研究
Suppadech Tunruttanakul1, Ratchanee Tunruttanakul2, Kamoltip Prasopsuk3
1Department of Surgery, Sawanpracharak Hospital, Nakhon Sawan, Thailand.
PloS one
|October 26, 2023
概括
大多数接受腹腔镜胆囊切除术的患者 (87.9%) 没有从手术前入院中获益. 只有12.1%的人可能需要接受必要的治疗,这表明需要重新评估当前的做法,以更好地管理资源.
科学领域:
- 手术创新 在外科创新.
- 医疗保健服务研究 医疗服务研究
- 胃肠病学 胃肠病学
背景情况:
- 腹腔镜胆囊切除术是一种常见的手术.
- 幼儿园的腹腔镜胆囊切除术在许多地区未得到充分利用.
- 传统的过夜协议可能会导致不必要的资源使用.
研究的目的:
- 评估选择性腹腔镜胆囊切除术的术前入院的必要性.
- 评估实施幼儿园腹腔镜胆囊切除术的可行性.
- 确定与需要进行手术前管理相关的因素.
主要方法:
- 405例选择性腹腔镜胆囊切除术病例的回顾性审查.
- 分析患者的人口统计,并发症和手术前管理.
- 统计分析包括费舍尔精确测试,t测试和后勤回归.
主要成果:
- 16.1%的患者接受了手术前治疗,其中21%是不必要的.
- 大约12.1%的患者理论上需要进行手术前入院.
- 随机疾病的增加与手术前管理的需要有显著的相关性 (OR 7.0-105.5).
- 发病率为4.2%,没有死亡率;手术取消率为0.5%.
结论:
- 显著的大多数腹腔镜胆囊切除术的术前入院可能不会提供治疗益处.
- 一小部分患者可能受益于手术前入院,主要是那些患有多种并发症的患者.
- 建议对传统的入院协议进行重新评估,以优化资源管理,并可能转向日托外科手术.
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