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日间甲状腺半切除术安全可行:苏格兰的经验

Day case hemithyroidectomy is safe and feasible: experience in Scotland.

作者信息

de Boisanger Louis, Blackwell Nicky, Magos Tiarnan, Adamson Richard, Hilmi Omar

机构信息

Medical Student, Department of Undergraduate Medical Studies, University of Glasgow, UK

ENT FY2, Department of ENT Surgery, St Johns Hospital, UK.

出版信息

Scott Med J. 2015 Nov;60(4):239-43. doi: 10.1177/0036933015584260. Epub 2015 Apr 29.

Abstract

BACKGROUND AND AIMS

We aimed to analyse the safety and feasibility of day case hemithyroidectomy.

METHODS AND RESULTS

We reviewed all hemithyroidectomies led by two surgeons across two sites between 2010 and the end of 2013. Patients were divided into 'planned inpatient' or 'planned day case'.

RESULTS

Day of discharge, conversion to inpatient procedure, intraoperative and postoperative complications and postoperative presentations or readmission to hospital were analysed. Age, gender, American Society of Anaesthesiologists score and indication for surgery were also recorded. One-hundred and eighty hemithyroidectomy cases were analysed, 35 (19.5%) were planned as inpatient procedures. Of the remaining 145 (80.5%) planned day case: 106 (73.1%) were successfully discharged on the same day and 39 (26.9%) were not; 11 (7.6%) were converted to inpatient procedures perioperatively; 8 (5.5%) had additional procedures; 6 (4.1%) had wound infections; 7 (4.8%) presented to ER; 1 (0.7%) of which required readmission to hospital for a reason unrelated to the surgery. None had laryngeal nerve palsy, compressive haematoma or symptomatic hypocalcaemia.

CONCLUSION

This study showed that hemithyroidectomy by experienced surgeons can be performed safely as a day surgery. No 'planned day case patients' in this study developed laryngeal nerve palsy, compressive haematoma or symptomatic hypocalcaemia.

摘要

背景与目的

我们旨在分析日间甲状腺半切术的安全性和可行性。

方法与结果

我们回顾了2010年至2013年底在两个地点由两位外科医生主导的所有甲状腺半切术病例。患者被分为“计划住院”或“计划日间手术”两类。

结果

分析了出院日期、转为住院手术、术中及术后并发症以及术后就诊或再次入院情况。还记录了患者的年龄、性别、美国麻醉医师协会评分和手术指征。共分析了180例甲状腺半切术病例,其中35例(19.5%)计划为住院手术。其余145例(80.5%)计划为日间手术:106例(73.1%)于同日成功出院,39例(26.9%)未同日出院;11例(7.6%)在围手术期转为住院手术;8例(5.5%)接受了额外手术;6例(4.1%)发生伤口感染;7例(4.8%)前往急诊室就诊;其中1例(0.7%)因与手术无关的原因需要再次入院。无一例发生喉返神经麻痹、压迫性血肿或有症状的低钙血症。

结论

本研究表明,经验丰富的外科医生进行的甲状腺半切术可作为日间手术安全实施。本研究中没有“计划日间手术患者”发生喉返神经麻痹、压迫性血肿或有症状的低钙血症。

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