Korsholm Malene, Mogensen Ole, Jeppesen Mette M, Lysdal Vibeke K, Traen Koen, Jensen Pernille T
Department of Gynecology and Obstetrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Int J Gynaecol Obstet. 2017 Feb;136(2):128-137. doi: 10.1002/ijgo.12023. Epub 2016 Nov 11.
Same-day discharge has been suggested to safe and acceptable following minimally invasive hysterectomy.
To evaluate the feasibility of same-day discharge following minimally invasive hysterectomy and to identify associated factors.
Medline, Embase and the Cochrane Central Register of Controlled Trials were systematically searched using the terms "same day discharge", "minimally invasive surgery", and "hysterectomy" between October 1 and October 31, 2015. No language or publication date restrictions were included.
Randomized controlled trials and observational studies evaluating same-day discharge before midnight on the day of minimally invasive hysterectomy were included.
Study characteristics, pre-operative selection criteria, and predictive factors for same-day discharge were analyzed.
There were 15 observational studies with 11 992 patients included. Significant heterogeneity was observed in the studies, and publication and selection bias could have potentially affected the results. All the studies concluded that same-day discharge was feasible. However, some factors were associated with a decreased possibility of same-day discharge; these were older age, beginning surgery later than 1:00 pm and completing surgery later than 6:00 pm, longer duration of operation, and high estimated blood loss.
Same-day discharge appears feasible for a majority of patients who undergo minimally invasive hysterectomies if adequate emphasis is placed on pre-surgical planning and careful patient selection.
有研究表明，微创子宫切除术后当日出院是安全且可接受的。
评估微创子宫切除术后当日出院的可行性，并确定相关因素。
于2015年10月1日至10月31日期间，使用“当日出院”“微创手术”和“子宫切除术”等检索词，对医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）和考克兰对照试验中心注册库进行系统检索。检索未设语言或出版日期限制。
纳入评估微创子宫切除术后当日午夜前出院情况的随机对照试验和观察性研究。
分析研究特征、术前选择标准以及当日出院的预测因素。
共纳入15项观察性研究，涉及11992例患者。研究中观察到显著的异质性，发表偏倚和选择偏倚可能对结果产生了潜在影响。所有研究均得出当日出院可行的结论。然而，某些因素与当日出院可能性降低相关，这些因素包括年龄较大、手术开始时间晚于下午1点、手术结束时间晚于下午6点、手术时间较长以及估计失血量较多。
如果充分重视术前规划并仔细选择患者，对于大多数接受微创子宫切除术的患者而言，当日出院似乎是可行的。
