Boama Vincent, Horton Joanne
Department of Obstetrics and Gynecology, Sidra Medical and Research Center, Po Box 26999, Doha, Qatar.
Department of Obstetrics and Gynecology, Hampshire Hospitals NHS Trust, Basingstoke, Hampshire, UK.
BMC Res Notes. 2016 Jan 6;9:13. doi: 10.1186/s13104-015-1795-3.
Around 2% of women develop a Bartholin's cyst or abscess at least once in their life time. The use of Word balloon catheter as an office procedure for the management of Bartholin's cyst and abscess has been well described and indicates high patient acceptance, low short-term recurrence rates and reduced cost. In most of the reported studies, the reduced costs are attributed to savings from equipment cost, operating theatre costs and health personnel costs. An evaluation of the actual clinical time gained with this office procedure has not been reported and hence the rationale for this study. This study was conducted from December 2011 to January 2014 on 35 patients. An initial retrospective clinical audit of 14 cases of marsupialization under general anesthetic between December 2011 and December 2012 was performed. The findings were compared with a subsequent prospective observational service evaluation of 21 consecutive patients between December 2012 and January 2014.
Compared to marsupialization under general anesthetic, the mean clinical time gained from admission to insertion of Word balloon catheter as an office procedure is 15 h and 40 min and the mean clinical time gained from admission to discharge is at least 24 h. There were very few minor complications and no major complications in the Word catheter group compared to the marsupialization group.
There is a clinically significant time gained with the use of Word balloon catheter as an office procedure compared to marsupialization under general anesthetic for Bartholin's cyst and abscess. The findings from our study could assist other units that want to adopt this procedure justify the efficiency savings in terms of clinical time gained when a business case is submitted. Further studies are needed to investigate and address the underlying causes for the delays encountered when marsupialization under general anesthetic is chosen by patients.
约2%的女性一生中至少会出现一次巴氏腺囊肿或脓肿。使用带蒂球囊导管作为门诊手术治疗巴氏腺囊肿和脓肿已得到充分描述，显示出患者接受度高、短期复发率低且成本降低。在大多数已报道的研究中，成本降低归因于设备成本、手术室成本和医护人员成本的节省。尚未有报道评估这种门诊手术实际节省的临床时间，因此开展了本研究。本研究于2011年12月至2014年1月对35例患者进行。对2011年12月至2012年12月期间14例在全身麻醉下进行袋形缝合术的病例进行了初步回顾性临床审计。将结果与随后对2012年12月至2014年1月期间连续21例患者进行的前瞻性观察性服务评估进行比较。
与全身麻醉下的袋形缝合术相比，作为门诊手术从入院到插入带蒂球囊导管平均节省的临床时间为15小时40分钟，从入院到出院平均节省的临床时间至少为24小时。与袋形缝合术组相比，带蒂导管组的轻微并发症极少，且无重大并发症。
与全身麻醉下的袋形缝合术治疗巴氏腺囊肿和脓肿相比，使用带蒂球囊导管作为门诊手术在临床上显著节省了时间。我们的研究结果可以帮助其他想要采用该手术的科室在提交商业案例时，从节省的临床时间方面证明效率提升的合理性。需要进一步研究调查并解决患者选择全身麻醉下袋形缝合术时出现延误的潜在原因。
