Giusto Laura L, Derisavifard Samir, Zahner Patricia M, Rueb Jessica J, Deyi Luo, Jiayi Li, Weilin Fang, de Jesus Moreira Raphael, Gomelsky Alexander, Balzarro Matteo, Goldman Howard B
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.
West China Hospital of Sichuan University, Chengdu, China.
Int Urogynecol J. 2022 Apr;33(4):1007-1015. doi: 10.1007/s00192-021-04767-1. Epub 2021 Apr 20.
The objective was to assess whether telemedicine-based follow-up is equivalent to office-based follow-up in the early postoperative period after routine synthetic midurethral sling placement.
This is a prospective, international, multi-institutional, randomized controlled trial. Patients undergoing synthetic midurethral sling placement were randomized to 3-week postoperative telemedicine versus office-based follow-up. The primary outcome was the rate of unplanned events. Secondary outcomes included patient satisfaction, crossover from telemedicine to office-based follow-up, and compliance with 3- to 5-month office follow-up.
We included 238 patients (telemedicine: 121 vs office: 117). No differences in demographics or medical comorbidities were noted between the study groups (p = 0.09-1.0). No differences were noted in unplanned events: hospital admission, emergency department visit, or unplanned office visit or call (14% vs 12.9%, p = 0.85) or complications (9.9% vs 8.6%, p = 0.82). Both groups were equally "very satisfied" with their surgical outcomes (71.1% vs 69%, p = 0.2). Telemedicine patients were more compliant with 3- to 5-month office follow-up (90.1% vs 79.3%, p = 0.04).
After synthetic midurethral sling placement, telemedicine follow-up is a safe patient communication option in the early postoperative period. Telemedicine patients reported no difference in satisfaction compared with office-based follow-up but had greater compliance with 3- to 5-month follow-up.
目的是评估在常规合成尿道中段吊带置入术后的早期,基于远程医疗的随访是否等同于门诊随访。
这是一项前瞻性、国际性、多机构随机对照试验。接受合成尿道中段吊带置入术的患者被随机分为术后3周接受远程医疗随访或门诊随访。主要结局是计划外事件的发生率。次要结局包括患者满意度、从远程医疗转为门诊随访的情况以及3至5个月门诊随访的依从性。
我们纳入了238例患者(远程医疗组:121例;门诊组:117例)。研究组之间在人口统计学或合并症方面无差异(p = 0.09 - 1.0)。计划外事件方面无差异:住院、急诊就诊、计划外门诊就诊或电话咨询(14%对12.9%,p = 0.85)或并发症(9.9%对8.6%,p = 0.82)。两组对手术结局的“非常满意”程度相同(71.1%对69%,p = 0.2)。远程医疗组患者对3至5个月门诊随访的依从性更高(90.1%对79.3%,p = 0.04)。
合成尿道中段吊带置入术后,远程医疗随访是术后早期安全的患者沟通方式。与门诊随访相比,远程医疗组患者的满意度无差异,但对3至5个月随访的依从性更高。