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妇科手术后的非计划性再次手术:来自约旦的报告。

Unplanned Reoperation Following Gynaecological Surgeries: A report from Jordan.

机构信息

Department of Obstetrics & Gynaecology, Faculty of Medicine, Al-Balqa Applied University, Amman, Jordan.

Gynecology & Obstetrics Section, The Specialty Hospital, Amman, Jordan.

出版信息

Sultan Qaboos Univ Med J. 2020 Nov;20(4):e368-e373. doi: 10.18295/squmj.2020.20.04.014. Epub 2020 Dec 21.

Abstract

OBJECTIVES

Unplanned return to the operating theatre refers to an unplanned reoperation following a primary surgical procedure and can result in serious complications. The rate of unplanned reoperations is often used as a measure of in-hospital quality monitoring and improvement. This study aimed to review the prevalence rate and features of unplanned gynaecological reoperations at a major general hospital in Jordan.

METHODS

This retrospective study took place between January 2011 and January 2018 at The Specialty Hospital in Amman, Jordan. The medical records of all women who underwent unplanned reoperations following a primary gynaecological procedure during this period were reviewed.

RESULTS

A total of 4,895 primary gynaecological procedures were performed during the study period, of which 4,175 (85.3%) were elective and 720 (14.7%) were emergency operations. There were 15 unplanned reoperations (0.3%); of these, 14 (93.3%) followed elective procedures and one (6.7%) followed an emergency surgery. Most reoperations were performed following hysterectomies (53.3%). Bleeding was the predominant reason for reoperation (93.3%), with the source of the bleeding successfully identified in 71.3% of cases. In terms of outcome, none of the cases required a subsequent reoperation and there were no mortalities.

CONCLUSION

The rate of unplanned reoperation at a hospital in Jordan was 0.3%. Unplanned reoperations occurred primarily as a result of bleeding following hysterectomies. Development of care pathways may reduce surgical complications and rates of unplanned reoperation.

摘要

目的

计划性重返手术室是指在初次手术后进行的非计划性再次手术,可能导致严重的并发症。非计划性再次手术的发生率通常被用作医院内质量监测和改进的衡量标准。本研究旨在回顾约旦一家大型综合医院妇科非计划性再次手术的发生率和特点。

方法

本回顾性研究于 2011 年 1 月至 2018 年 1 月在约旦安曼的专科医院进行。回顾了在此期间因初次妇科手术后进行非计划性再次手术的所有女性的病历。

结果

在研究期间共进行了 4895 例初次妇科手术,其中 4175 例(85.3%)为择期手术,720 例(14.7%)为急诊手术。共有 15 例非计划性再次手术(0.3%);其中 14 例(93.3%)为择期手术,1 例(6.7%)为急诊手术。大多数再次手术是在子宫切除术后进行的(53.3%)。出血是再次手术的主要原因(93.3%),其中 71.3%的病例成功确定了出血源。就结局而言,没有一个病例需要再次手术,也没有死亡。

结论

约旦一家医院的非计划性再次手术发生率为 0.3%。非计划性再次手术主要是由于子宫切除术后出血引起的。制定护理路径可能会减少手术并发症和非计划性再次手术的发生率。

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本文引用的文献

3
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Standards for gynecologic surgery.妇科手术标准。
J Obstet Gynaecol India. 2013 Mar;63(1):7-13. doi: 10.1007/s13224-013-0405-3. Epub 2013 Apr 26.
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Unplanned return to the operating theatre in gynaecology: five years' experience.妇科手术中的非计划性重返手术室:五年经验。
Eur J Obstet Gynecol Reprod Biol. 2011 Aug;157(2):222-5. doi: 10.1016/j.ejogrb.2011.03.019. Epub 2011 Apr 19.

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