Voorbrood C E H, Burgmans J P J, Clevers G J, Davids P H P, Verleisdonk E J M M, Schouten N, van Dalen T
Department of Surgery/Hernia Clinic, Diakonessenhuis Utrecht/Zeist, Room: Secretariaat Heelkunde, Professor Lorentzlaan 76, 3707 HL, Zeist, The Netherlands,
Hernia. 2015 Jun;19(3):395-400. doi: 10.1007/s10029-013-1151-2. Epub 2013 Aug 15.
One-stop surgery offers patients diagnostic work-up and subsequent surgical treatment on the same day. In the present study, patient satisfaction and efficiency from an institutional perspective were evaluated in patients who were referred for one-stop endoscopic inguinal hernia repair.
In a high-volume inguinal hernia clinic, all consecutive patients referred for one-stop surgical treatment, were registered prospectively. An instructed secretary screened patients for eligibility for the one-stop option when the appointment was made. Totally extraperitoneal hernia repair under general anaesthesia was the preferred operative technique. Patient's satisfaction, successful day surgery and institutional efficiency were evaluated.
Between January 2010 and January 2012 a total of 349 patients (17 % of all patients in the hernia clinic) were referred for one-stop hernia repair. Mean age was 47.5 years and 96.3 % were males. Three hundred thirty-six patients underwent hernia surgery on the same day (96.3 %). In thirteen patients (3.7 %) no operative repair was done on the day of presentation due to an incorrect diagnosis (n = 7), a watchful waiting policy for asymptomatic hernia (n = 3), rescheduling due to a large scrotal hernia, and there were two "no shows". Following hernia repair 97 % of the patients were discharged on the same day, while ten patients required hospitalization. Based on the questionnaires the main satisfaction score among patients was 9.0 (8.89-9.17 95 % CI) on a scale ranging from 0 to 10.
One-stop hernia surgery is feasible and satisfactory from an institutional as well as from a patient's perspective.
一站式手术为患者提供了在同一天进行诊断检查及后续手术治疗的服务。在本研究中，我们从机构角度评估了因腹股沟疝而行一站式内镜修补术患者的满意度和效率。
在一家高容量腹股沟疝诊所，对所有连续接受一站式手术治疗的患者进行前瞻性登记。在预约时，由一名经过培训的秘书筛选患者是否适合一站式手术方案。全身麻醉下的完全腹膜外疝修补术是首选的手术技术。评估患者的满意度、当日手术成功率和机构效率。
2010年1月至2012年1月期间，共有349例患者（占疝诊所所有患者的17%）被转诊接受一站式疝修补术。平均年龄为47.5岁，男性占96.3%。336例患者在同一天接受了疝手术（96.3%）。13例患者（3.7%）在就诊当天未进行手术修补，原因包括诊断错误（n = 7）、对无症状疝采取观察等待策略（n = 3）、因巨大阴囊疝重新安排手术时间以及有2例患者未到诊。疝修补术后，97%的患者在同一天出院，10例患者需要住院治疗。根据问卷调查，患者的主要满意度评分为9.0（8.89 - 9.17，95%置信区间），评分范围为0至10分。
从机构和患者的角度来看，一站式疝手术是可行且令人满意的。
