Department of Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands.
Br J Surg. 2010 Feb;97(2):189-94. doi: 10.1002/bjs.6812.
: Short-stay breast cancer surgery (24 h or day case) is not common practice in Europe. This before-after comparative study was carried out to test the feasibility of systematically implementing a care programme incorporating short-stay admission using strategies tailored to individual hospital needs, and to assess safety and facilitating factors.
: Patients with breast cancer from four Dutch hospitals participated. The intervention concerned the programme developed by the Maastricht University Medical Centre. This was implemented through local multidisciplinary meetings and educational outreach visits.
: Of 421 eligible patients, 324 (77.0 per cent) gave consent to participate. The proportion of patients who had short-stay treatment increased from 45.3 per cent before to 82.2 per cent after implementation of the programme (P < 0.001). No increase was observed in the rate of complications, readmissions, reoperations or number of visits to the emergency department. Factors associated with an increased chance of short-stay treatment were: breast-conserving surgery, having children and being employed. Being aged over 64 years showed a trend towards a decreased chance.
: Introducing a care programme incorporating short stay following breast cancer surgery in four hospitals was feasible and safe.
在欧洲，24 小时或日间乳腺癌手术（短期住院手术）并不常见。本项前后对照研究旨在检验系统实施包含短期住院的护理方案的可行性，该方案采用了针对各医院具体需求定制的策略，并评估其安全性和促进因素。
来自荷兰四家医院的乳腺癌患者参与了本研究。干预措施涉及由马斯特里赫特大学医学中心制定的方案。该方案通过当地多学科会议和教育外展访问来实施。
在 421 名符合条件的患者中，有 324 名（77.0%）同意参与。实施该方案后，接受短期治疗的患者比例从之前的 45.3%增加到 82.2%（P < 0.001）。并发症、再入院、再次手术或急诊就诊次数均未增加。与短期住院治疗机会增加相关的因素包括：保乳手术、有子女和有工作。年龄超过 64 岁则呈短期住院治疗机会减少的趋势。
在四家医院引入包含乳腺癌手术后短期住院的护理方案是可行且安全的。
