Jefferis Helen, Muriithi Francis, White Beverly, Price Natalia, Jackson Simon
Department of Gynaecology, The Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Headley Way, Oxford, OX3 9DU, UK.
Int Urogynecol J. 2016 May;27(5):787-90. doi: 10.1007/s00192-015-2891-6. Epub 2015 Nov 21.
Post-operative review allows assessment of individual patient outcome, evaluation of any ongoing symptoms and an audit of departmental surgical outcome and therefore represents best clinical practice. Current TVT surgery follow-up practice varies widely, with most centres routinely seeing patients face to face in an outpatient setting. However, unnecessary outpatient attendance can be inefficient and inconvenient for patients and staff. One proposed alternative is telemedical follow-up, as introduced by our unit in 2010. We report on 5 years of experience with telephone follow-up.
The British Society of Urogynaecology (BSUG) database was searched for all cases of primary retropubic TVT slings performed by the unit in the period 1 January 2010 to 31 December 2014. Cases identified from the BSUG database then had their case notes reviewed. Patients having additional surgery were excluded from analysis. This yielded a cohort of 356 patients. No ethical approval was required for this investigation as it was a simple observational study (clinical audit).
Two hundred and sixty-two patients were initially followed up via telephone; the remaining 94 were seen in a conventional outpatient clinic setting. Of the 262 followed up by telephone, 28 patients (10 %) subsequently required review in an outpatient clinic for a variety of reasons.
Telephone follow-up is an appropriate mode of follow-up for uncomplicated primary incontinence surgery. By using telemedicine, 234 patients who would previously have been seen in clinic were followed up remotely, saving valuable clinic time for patients with greater clinical need.
术后复查有助于评估个体患者的治疗效果,评估任何持续存在的症状,并对科室手术结果进行审核,因此代表了最佳临床实践。目前经阴道无张力尿道中段吊带术(TVT)的随访实践差异很大,大多数中心通常在门诊环境中让患者面对面就诊。然而,不必要的门诊就诊对患者和工作人员来说效率低下且不便。一种提议的替代方法是远程医疗随访,这是我们科室在2010年引入的。我们报告了5年电话随访的经验。
在英国泌尿妇科协会(BSUG)数据库中搜索该科室在2010年1月1日至2014年12月31日期间进行的所有原发性耻骨后TVT吊带手术病例。从BSUG数据库中识别出的病例随后对其病历进行了审查。接受额外手术的患者被排除在分析之外。这产生了一组356例患者。由于这是一项简单的观察性研究(临床审核),该调查无需伦理批准。
262例患者最初通过电话进行随访;其余94例在传统门诊环境中就诊。在通过电话随访的262例患者中,28例(10%)随后因各种原因需要在门诊进行复查。
电话随访是单纯性原发性尿失禁手术合适的随访方式。通过使用远程医疗,234例原本需要在门诊就诊的患者得以远程随访,为有更大临床需求的患者节省了宝贵的门诊时间。