腹腔镜食管裂孔疝修补术作为日间手术：可行性、短期结果和成本。
Laparoscopic hiatal hernia repair as same day surgery: Feasibility, short-term outcomes and costs.
机构信息
McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), United States.
Memorial Hermann Southeast Esophageal Disease Center, United States.
出版信息
Am J Surg. 2020 Dec;220(6):1438-1444. doi: 10.1016/j.amjsurg.2020.09.009. Epub 2020 Sep 6.
INTRODUCTION
Laparoscopic hiatal hernia repair is commonly performed with 1 night hospitalization. The aim was to assess repairs as same-day-surgery (SDS).
METHODS
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.
RESULTS
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.
CONCLUSION
Laparoscopic hiatal hernia repair can be performed as SDS in majority of elective repairs with good short-term outcomes and reduced cost.
简介
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。
方法
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。
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。
结论
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。
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