在妇科瘤学中启动同日出院途径:来自北克的质量改进经验
Maite Skowronski1, Gabriel Levin2, Lucy Gilbert2
1Research Institute - McGill University Health Centre, McGill University, QC, Canada.
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC
|March 12, 2026
概括
在微创性子宫切除术后,同日出院在90%以上的患者中是可行的,再入院的患者很少. 较高的BMI和ASA等级3是失败出院的预测因素,表明需要优化患者途径.
科学领域:
- 妇科瘤学 妇科瘤学
- 最少侵入性的手术
- 外科手术的结果
背景情况:
- 手术后增强恢复 (ERAS) 协议和最小侵入性手术 (MIS) 促进妇科瘤学同日出院.
- 同日出院的实施情况各不相同,加拿大数据有限.
研究的目的:
- 在加拿大背景下评估微创性子宫切除术后在同一天出院的可行性和结果.
- 为了确定未能在同一天出院和计划外再接收的预测因素.
主要方法:
- 对159名患者进行回顾性队列研究,这些患者接受了计划进行门诊治疗的微创性子宫切除术 (腹腔镜或机器人).
- 收集的数据包括人口统计,术后变量和手术复杂性.
- 失败的当天出院被定义为无计划的术后入院; 分析了入院/再入院的预测因素.
主要成果:
- 92.5%的患者 (147/159) 获得了当天出院.
- 不能在同一天出院的患者的体重指数 (BMI) 显着更高,并且更有可能成为ASA类3或术后到达时间较晚.
- 在67.3%的病例中进行了 laparoscopic 子宫切除术,在32.7%的病例中进行了机器人切除术,子宫内膜癌是最常见的征兆.
结论:
- 经过微创性切除子宫术后的当天出院对于大多数患者来说是一种安全和可行的选择,成功率超过90%.
- 较高的BMI和ASA等级3是失败当天出院的重要预测因素.
- 对于具有已识别的风险因素的患者,建议进行手术前咨询和途径优化,以进一步提高当天出院率.
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