Ma Yi, Jones Gregory, Tay Yeng Kwang, Hunter Toni, Holden Dane, Rodgers-Wilson Stephen, Cashin Paul, Tan Pee Yau, Croagh Daniel
Department of Upper GI and Hepatobiliary Surgery, Monash Medical Centre, Melbourne, Victoria, Australia.
Department of General Surgery, Dandenong Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2018 May;88(5):434-439. doi: 10.1111/ans.14280. Epub 2017 Dec 5.
Studies have shown that post-operative telephone follow-up is satisfactory and effective. As high quality evidence is scant, we conducted a randomized controlled trial to compare it against outpatient clinic review for emergency laparoscopic appendicectomy or cholecystectomy.
Patients who received emergency laparoscopic appendicectomy or cholecystectomy were eligible for this study. Once recruited, they were randomly allocated to either clinic review or telephone follow-up on discharge. Participants were reviewed at 2 weeks after operation and contacted again at 4 weeks after initial follow-up for satisfaction survey.
One hundred and seventy-nine participants were recruited with one withdrawn consent and six excluded. Ninety-six underwent laparoscopic appendicectomy and 76 had laparoscopic cholecystectomy. Ninety-six attended clinic review and 76 had telephone follow-up. The two groups were similar in baseline variables. Non-attendance rate was higher for clinic review cohort (24% vs 6.6%, P = 0.002). Participants who received telephone review reported higher satisfaction level (9.31 vs 8.85, P = 0.002), and most patients prefer telephone follow-up (73.1%, P < 0.0001). No difference was detected for missed complications (P = 0.354).
Telephone follow-up post laparoscopic appendicectomy or cholecystectomy is safe, satisfying and effective.
研究表明，术后电话随访令人满意且有效。由于高质量证据匮乏，我们开展了一项随机对照试验，将其与急诊腹腔镜阑尾切除术或胆囊切除术后的门诊复查进行比较。
接受急诊腹腔镜阑尾切除术或胆囊切除术的患者符合本研究条件。一旦入选，他们在出院时被随机分配至门诊复查组或电话随访组。在术后2周对参与者进行复查，并在首次随访后4周再次联系以进行满意度调查。
共招募了179名参与者，其中1人撤回同意书，6人被排除。96例行腹腔镜阑尾切除术，76例行腹腔镜胆囊切除术。96人接受门诊复查，76人接受电话随访。两组的基线变量相似。门诊复查队列的未就诊率更高（24%对6.6%，P = 0.002）。接受电话复查者报告的满意度更高（9.31对8.85，P = 0.002），且大多数患者更喜欢电话随访（73.1%，P < 0.0001）。在漏诊并发症方面未发现差异（P = 0.354）。
腹腔镜阑尾切除术或胆囊切除术后的电话随访安全、令人满意且有效。
