McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), United States.
Memorial Hermann Southeast Esophageal Disease Center, United States.
Am J Surg. 2020 Dec;220(6):1438-1444. doi: 10.1016/j.amjsurg.2020.09.009. Epub 2020 Sep 6.
Laparoscopic hiatal hernia repair is commonly performed with 1 night hospitalization. The aim was to assess repairs as same-day-surgery (SDS).
Costs/short-term outcomes of SDS were compared to hospital-stay < 24-h: observation (OBS) and hospital-stay ≥ 24-h: inpatient (INP). Outcomes were assessed by postoperative 30-day ER visits/readmissions.
There were 262 procedures, excluding 50 reoperative repairs, 212 procedures were included: There were 66 SDS, 65 OBS and 81 INP. SDS vs. OBS: OBS were older, had higher ASA, less type I and more type III and IV hernias. Costs were significantly less in the SDS group with no difference in post-operative ER visits/post-discharge readmissions. SDS vs. INP: INP were older, had higher ASA, less type I and more type III and IV hernias. Costs were significantly less in the SDS group with no difference in post-operative ER visits/post-discharge readmissions.
Laparoscopic hiatal hernia repair can be performed as SDS in majority of elective repairs with good short-term outcomes and reduced cost.
腹腔镜食管裂孔疝修补术通常在住院 1 晚后进行。目的是评估作为日间手术（SDS）的修复。
比较 SDS 的成本/短期结果与住院时间<24 小时：观察（OBS）和住院时间≥24 小时：住院（INP）。通过术后 30 天急诊就诊/再入院评估结果。
共进行了 262 例手术，不包括 50 例再次手术修复，纳入 212 例手术：有 66 例 SDS、65 例 OBS 和 81 例 INP。SDS 与 OBS：OBS 年龄较大，ASA 较高，I 型较少，III 型和 IV 型疝较多。SDS 组的成本明显较低，术后急诊就诊/出院后再入院率无差异。SDS 与 INP：INP 年龄较大，ASA 较高，I 型较少，III 型和 IV 型疝较多。SDS 组的成本明显较低，术后急诊就诊/出院后再入院率无差异。
腹腔镜食管裂孔疝修补术在大多数择期修复中可作为 SDS 进行，具有良好的短期结果和降低成本。
