Capmas P, Nazac A, Jennequin C, Fernandez H
Service de gynécologie obstétrique, hôpital Bicêtre, AP-HP, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; Inserm, CESP, U1018, 94276 Le Kremlin-Bicêtre, France; Université Paris-Sud, 94275 Le Kremlin-Bicêtre cedex, France.
Service de gynécologie obstétrique, hôpital Bicêtre, AP-HP, 78, avenue du Général-Leclerc, 94275 Le Kremlin-Bicêtre cedex, France; CNRS UMR 7647, École polytechnique, 91120 Palaiseau, France.
J Gynecol Obstet Biol Reprod (Paris). 2014 Apr;43(4):294-9. doi: 10.1016/j.jgyn.2013.09.006. Epub 2013 Oct 25.
Study feasibility of outpatient management for gynaecologic surgery.
Monocentric cohort analysis to study outpatient management in a gynaecologic department from January 2010 to December 2011. Number of second hospitalization in the month following ambulatory care was collected.
Two thousand eight hundred and three interventions were performed including 1425 (51%) in outpatient management. Four women had a second hospitalization in the month following ambulatory care and none of them had a second surgery. For gynaecologic "tracer act", that required an 80% rate of outpatient management in France (operative hysteroscopy, conisation and breast tumorectomy), the rate of outpatient management was 86%.
Outpatient care is feasible in gynaecologic surgery and objective of an 80% rate of ambulatory care for some specific gynaecologic interventions is reasonable without additional risk. A large outpatient management is feasible keeping in mind that it is women that are concern with ambulatory care and not interventions. Choosing an outpatient care is based on the risk-benefit balance.
研究妇科手术门诊管理的可行性。
采用单中心队列分析，对2010年1月至2011年12月某妇科门诊管理情况进行研究。收集门诊治疗后当月再次住院的人数。
共进行了2803例干预措施，其中1425例（51%）为门诊管理。4名女性在门诊治疗后的当月再次住院，且均未接受二次手术。对于法国要求门诊管理率达到80%的妇科“追踪手术”（手术宫腔镜检查、锥切术和乳腺肿瘤切除术），门诊管理率为86%。
妇科手术的门诊治疗是可行的，对于某些特定妇科手术而言，80%的门诊治疗目标合理且无额外风险。大规模的门诊管理是可行的，但要记住接受门诊治疗的是女性而非手术本身。选择门诊治疗应基于风险效益平衡。
