与开腹远端胰腺切除术相比，将再入院天数计入初始术后住院时间会限制腹腔镜远端胰腺切除术的感知益处。
Adding days spent in readmission to the initial postoperative length of stay limits the perceived benefit of laparoscopic distal pancreatectomy when compared with open distal pancreatectomy.
机构信息
Department of Surgery, University of Chicago, Evanston, IL 60201, USA.
出版信息
Am J Surg. 2011 Mar;201(3):295-9; discussion 299-300. doi: 10.1016/j.amjsurg.2010.09.014.
BACKGROUND
Published comparisons of laparoscopic (laparoscopic distal pancreatectomy [LDP]) to open distal pancreatectomy (ODP) identify improved lengths of stay (LOS) after LDP but do not include data on readmissions.
METHODS
Demographic, operative, and postoperative outcomes data for patients undergoing LDP or ODP between August 2007 and December 2009 were culled from our prospectively accruing pancreatic database. Electronic medical records were reviewed to determine cause, treatment, and LOS for readmissions.
RESULTS
Patients undergoing LDP were statistically identical to those undergoing ODP in regard to age, presentation, demographic characteristics, comorbidities, operative times, tumor sizes, morbidity, mortality, and pancreatic fistula rates. The initial LOS was statistically shorter for those undergoing LDP (4.8 ± .1 days vs 8.7 ± .1 days, P < .001). The readmission rate for LDP was statistically higher than for ODP (25% vs 8%, P < .05). Overall LOS for LDP was 7.2 ± .3 days versus 9.3 ± .1 days for ODP (P = .2).
CONCLUSIONS
Adding readmission LOS to initial LOS eliminates the perceived effect of LDP to accelerate recovery.
背景
已发表的腹腔镜（腹腔镜胰体尾切除术[LDP]）与开腹胰体尾切除术（ODP）的比较研究确定了 LDP 后住院时间（LOS）的改善，但不包括再入院数据。
方法
从我们前瞻性积累的胰腺数据库中提取了 2007 年 8 月至 2009 年 12 月期间接受 LDP 或 ODP 的患者的人口统计学、手术和术后结果数据。审查电子病历以确定再入院的原因、治疗和 LOS。
结果
LDP 组患者在年龄、表现、人口统计学特征、合并症、手术时间、肿瘤大小、发病率、死亡率和胰瘘发生率方面与 ODP 组患者统计学上无差异。接受 LDP 的患者的初始 LOS 统计学上更短（4.8±0.1 天 vs 8.7±0.1 天，P<0.001）。LDP 的再入院率统计学上高于 ODP（25% vs 8%，P<0.05）。LDP 的总 LOS 为 7.2±0.3 天，而 ODP 为 9.3±0.1 天（P=0.2）。
结论
将再入院 LOS 添加到初始 LOS 中，消除了 LDP 加速康复的感知效果。
Zotero 插件