Clair D L, Caldamone A A
Department of Urology, Brown University, Providence, Rhode Island.
Urol Clin North Am. 1988 Nov;15(4):715-23.
The practice of pediatric urology has changed much during the last 25 years. Procedures that were once done only on inpatients are now done as ambulatory cases, comprising more than 60 per cent of all surgery. This trend has continued, with even more cases being done as office procedures. These consist of circumcision, meatotomy for stenosis, lysis of labial adhesions, and meatal dilatation after hypospadias repair. If an operation is done with attention to detail, it can be completed with minimal complications, although, as evidenced with circumcision, those that do occur can carry significant morbidity and even cause death. The primary limiting factor for performing procedures in the office is the comfort of the patient. The procedure, by necessity, has to entail minimum pain and great ease in obtaining hemostasis and requires a cooperative patient and family. Therefore, even as the number of operations performed on an out-patient basis increases, there are a finite number of cases suitable for the office.
在过去25年里，小儿泌尿外科的诊疗方式发生了很大变化。曾经仅在住院患者中进行的手术，如今已作为门诊病例开展，占所有手术的60%以上。这一趋势仍在持续，甚至更多的病例以门诊手术的形式进行。这些手术包括包皮环切术、尿道外口狭窄切开术、阴唇粘连松解术以及尿道下裂修复术后的尿道口扩张术。如果手术时注重细节，尽管会有并发症发生，但可以将其降至最低，不过，以包皮环切术为例，确实发生的并发症可能会导致严重的发病率甚至死亡。在门诊进行手术的主要限制因素是患者的舒适度。该手术必然需要将疼痛降至最低，在止血方面要操作简便，并且需要患者及其家属配合。因此，即使门诊手术的数量在增加，但适合在门诊进行的病例数量仍然有限。
