Sanges G, Astuto M, Sentina P, Morinello E, Di Benedetto A
Università degli Studi di Catania, Azienda Policlinico, U.O. di Chirurgia Pediatrica, Via S. Sofia 86, 95125 Catania.
Pediatr Med Chir. 2002 Jul-Aug;24(4):289-92.
The One-Stop Surgery (OSS) is a new method of Day Surgery, which combines preoperative evaluation and subsequent operation into one visit. This report describes the initial experience of the authors. Referring physicians were informed by fax about method and selected surgical procedures. Included form helped them to gain anamnestic data and to inform parents about preoperative fast. Form was then sent back by fax to the pediatric surgeon and anesthesiologist who determined the patient suitability and scheduled the day of the surgery. At hospital admission, if the diagnosis was confirmed and no anesthesiologic contraindications were discovered, the patient underwent the prescheduled surgical procedure and was discharged as a day case. Another form containing informations about home postoperative care and telephone numbers for emergency call was gave to the parents. From November 2000 through February 2001 43 patients, aged from 2 to 7 years, underwent one-stop surgical procedure: central venous catheter removal (n = 16), umbilical (n = 2) and inguinal (n = 10) hernia repair, prepuce dorsal slit (n = 15). Recovery of all patient was uneventful. None of them called during the period considered necessary for postoperative follow-up. Decreased costs and increased satisfaction of the patients and parents are the most important advantages of the OSS. Potential disadvantages are a not appropriate indication for the planned procedure and/or an anesthesiologic contraindication at hospital admission. It could involve a waste of human and financial resources and an useless psychologic stress for the family. Authors conclude it is not advisable the OSS use on a large scale without a sound experience in pediatric Day Surgery.
一站式手术(OSS)是日间手术的一种新方法,它将术前评估和后续手术合并为一次就诊。本报告描述了作者的初步经验。通过传真向转诊医生告知该方法及所选手术程序。所附表格帮助他们获取记忆性数据,并告知家长术前禁食事宜。然后表格通过传真发回给确定患者是否适合并安排手术日期的小儿外科医生和麻醉医生。入院时,如果诊断得到确认且未发现麻醉禁忌证,患者接受预定的手术程序,并作为日间病例出院。另一份包含术后家庭护理信息及紧急呼叫电话号码的表格交给了家长。从2000年11月至2001年2月,43名年龄在2至7岁的患者接受了一站式手术:中心静脉导管拔除(n = 16)、脐疝(n = 2)和腹股沟疝修补术(n = 10)、包皮背侧切开术(n = 15)。所有患者恢复顺利。在术后随访所需的时间段内,他们均未打电话。成本降低以及患者和家长满意度提高是一站式手术的最重要优点。潜在的缺点是计划手术的适应证不合适和/或入院时存在麻醉禁忌证。这可能会造成人力和财力资源的浪费以及给家庭带来不必要的心理压力。作者得出结论,在小儿日间手术没有丰富经验的情况下,大规模使用一站式手术是不可取的。