门诊乳房切除术
Ambulatory mastectomy.
作者信息
Dooley William C
机构信息
University of Oklahoma Breast Institute, 825 NE 10th St., Suite 5200, Oklahoma Health Sciences Center, Oklahoma City 73104, USA.
出版信息
Am J Surg. 2002 Dec;184(6):545-8; discussion 548-9. doi: 10.1016/s0002-9610(02)01051-6.
BACKGROUND
Ambulatory mastectomy has been a topic of heated political debate with little analysis of clinical data.
METHODS
Based on extensive satisfaction surveys, an ideal surgical treatment experience was developed that decreased nausea, increased preoperative education, and reduced perioperative narcotic usage. Using this new algorithm, patients treated by a single surgeon were given the choice of overnight stay versus discharge to home with visiting nurse care.
RESULTS
From March 1 to October 31, 2001, 92 mastectomies or lumpectomy/axillary dissections were performed in 87 patients. One patient chose to remain in the center overnight. All others were discharged in less than 2.5 hours postoperatively. Perioperative complications fell to 20% of those of the prior year. Hospital charges fell 79.5%.
CONCLUSIONS
Despite lay reservations about ambulatory mastectomy, a detailed approach can result in markedly reduced health care costs without incurring additional morbidity or mortality.
背景
门诊乳房切除术一直是激烈政治辩论的话题，而对临床数据的分析却很少。
方法
基于广泛的满意度调查，制定了一种理想的手术治疗方案，该方案可减少恶心、增加术前教育并减少围手术期麻醉剂的使用。采用这种新算法，由单一外科医生治疗的患者可以选择过夜留院或在有访视护士护理的情况下出院回家。
结果
2001年3月1日至10月31日，87例患者接受了92例乳房切除术或肿块切除术/腋窝淋巴结清扫术。1例患者选择在中心过夜。所有其他患者在术后不到2.5小时出院。围手术期并发症降至前一年的20%。医院费用下降了79.5%。
结论
尽管外行对门诊乳房切除术有所保留，但一种详细的方法可以显著降低医疗成本，而不会增加发病率或死亡率。
Zotero 插件