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远程医疗随访用于合成尿道中段吊带术是安全有效的:一项随机、多机构对照试验。

Telemedicine follow-up is safe and efficacious for synthetic midurethral slings: a randomized, multi-institutional control trial.

作者信息

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

机构信息

Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA.

West China Hospital of Sichuan University, Chengdu, China.

出版信息

Int Urogynecol J. 2022 Apr;33(4):1007-1015. doi: 10.1007/s00192-021-04767-1. Epub 2021 Apr 20.

Abstract

INTRODUCTION AND HYPOTHESIS

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

引言与假设

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。

方法

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。

结果

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)。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00d3/8056194/01b3eae5590c/192_2021_4767_Fig1_HTML.jpg

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