微创性大肠切除术后当天出院:成功的患者选择方法
Daniel Aillaud-De-Uriarte1,2, Luis A Hernandez-Flores1, Andrea Hernandez-Moreno1
1Division of Colon and Rectal Surgery, Houston Methodist Willowbrook Hospital, Houston, USA.
Cureus
|September 20, 2024
概括
经过微创性切除术后的当日出院是可行的,使用了手术后增强恢复 (ERAS) 协议. 仔细选择患者是确保安全和避免再入院的关键.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 最少侵入性手术的方法
背景情况:
- 手术后增强恢复 (ERAS) 协议减少了停留时间 (LOS) 并改善了选择性结直肠手术的结果.
- 切口术后的当日出院 (SDD) 是一个复杂的决定,受患者因素,社会支持和康复状态的影响.
- 在社区医院环境中,ERAS协议越来越多地被实施.
研究的目的:
- 为了评估在微创科切除术后同日出院 (SDD) 的结果.
- 在社区医院的ERAS协议中评估SDD的安全性和可行性.
- 确定影响科切除术后成功SDD的因素.
主要方法:
- 由单个外科医生进行的选择性最小侵入性切除术的回顾性队列研究.
- 分析2022年4月至2023年4月的患者数据.
- 使用费舍尔精确测试和曼-惠特尼U测试,对当天出院和过夜组之间的结果进行比较.
主要成果:
- 47.7%的患者 (41/86) 在同一天出院.
- 在SDD组中没有报告再入院,而在过夜组中则为3.4%.
- 整个队伍的中位数LOS为一天.
结论:
- 经过最小侵入性切除术后,在同一天出院是可行的,有了建立的ERAS协议和足够的患者/工作人员教育.
- 仔细选择患者,考虑并发症和社会支持,对于成功的SDD至关重要.
- 在ERAS框架内的SDD可以在特定患者中安全有效.
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