Azawi Nessn H, Christensen Tom, Petri Anette Lykke, Kehlet Henrik
Urologisk Afdeling D, Roskilde Hospital, 4000 Roskilde, Denmark.
Dan Med J. 2012 Jun;59(6):A4446.
Implementation of the principles of a fast-track surgical programme resulted in a decrease in the length of hospital stay after open nephrectomies. The aim of this study was to describe the regional distribution of nephrectomies, postoperative hospital stay and mortality.
This study was based on data extracted from the Danish National Patient Registry for the 2000-2009-period.
A total of 6,790 nephrectomies were performed. The mean postoperative stay and mortality decreased from 10.1 days and 2.6% during the 2000-2004-period to 8.3 days (p > 0.05) and 1.7% (p < 0.05) during the 2005-2009-period. A significant decrease in length of postoperative stay (6.4 versus 9.0 days; p < 0.05) and mortality (0.9% versus 2.1%; p < 0.05) was found between laparoscopic and open nephrectomies, respectively, during the 2005-2009-period. Nephrectomies performed by laparoscopic technique rose from 7.6% to 30.8% (p < 0.05) and laparoscopic nephroureterectomies from 1.7% to 10.3% (p < 0.05) from the 2000-2004-period to the 2005-2009-period.
We recommend the implementation of fast-track surgery programmes to further decrease postoperative stay and mortality. A further increase in the use of laparoscopy is warranted.
实施快速康复外科计划的原则导致开放性肾切除术后住院时间缩短。本研究的目的是描述肾切除术的区域分布、术后住院时间和死亡率。
本研究基于从丹麦国家患者登记处提取的2000 - 2009年期间的数据。
共进行了6790例肾切除术。术后平均住院时间和死亡率从2000 - 2004年期间的10.1天和2.6%降至2005 - 2009年期间的8.3天(p>0.05)和1.7%(p<0.05)。在2005 - 2009年期间,腹腔镜肾切除术和开放性肾切除术的术后住院时间(分别为6.4天和9.0天;p<0.05)和死亡率(分别为0.9%和2.1%;p<0.05)均有显著下降。从2000 - 2004年期间到2005 - 2009年期间,采用腹腔镜技术进行的肾切除术从7.6%升至30.8%(p<0.05),腹腔镜肾输尿管切除术从1.7%升至10.3%(p<0.05)。
我们建议实施快速康复外科计划以进一步缩短术后住院时间和降低死亡率。有必要进一步增加腹腔镜手术的应用。