大肠切除后的通用同日排泄:一项匹配的队列研究.
Tommaso Violante1,2, Davide Ferrari3, Ibrahim A Gomaa3
1Division of Colon and Rectal Surgery, Mayo Clinic, 200 First St. Southwest, Rochester, MN, 55905, USA. tommyviolante@gmail.com.
Updates in surgery
|July 14, 2025
概括
结直肠外科手术后的通用同日出院 (USDD) 是安全的,并且对于选定的患者来说,与传统的增强恢复协议 (ERP) 不逊色. 虽然并发症和重新手术情况相似,但当天出院的患者在急诊室的访问和再入院的次数更高.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 患者出院协议 患者出院协议
背景情况:
- 增强恢复协议 (ERP) 显著改善了结直肠外科手术的结果.
- 同日出院 (SDD) 是一个有前途的进步,但通常仅限于精选的患者.
- 将SDD扩展到更广泛的患者群体需要仔细评估.
研究的目的:
- 评估通用同日放电 (USDD) 计划的安全性和有效性.
- 在更广泛的患者群体中,将USDD与传统ERP进行比较.
- 评估USDD在30天并发症,再入院和重新手术方面的非劣势.
主要方法:
- 在一个单一的美国机构进行了回顾性匹配队列研究.
- 在USDD计划中对36名患者进行比较,与在传统ERP中匹配的对照组进行比较.
- USDD资格:门诊协议,微创手术,没有新的口腔,护理人员支持.
主要成果:
- USDD 组表现出更短的手术时间,增加了横腹平面 (TAP) 块的使用,并减少了手术内液体的使用.
- 在USDD和ERP组之间,在30天的术后并发症或重新手术中没有显著差异.
- 在USDD群体中,观察到急诊室访问和再接收的比例更高.
结论:
- 全球同日出院 (USDD) 似乎是安全的,并且对于选定的结直肠手术患者来说,与传统的ERP不逊色.
- SDD可以安全地扩展到更广泛的患者群体.
- 需要进一步的前性研究来验证这些发现并优化USDD协议.
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