MultiCare Health Network, Tacoma, WA, 98405, USA.
University of Portland, Portland, OR, 97203, USA.
Surg Endosc. 2023 Jan;37(1):134-139. doi: 10.1007/s00464-022-09446-w. Epub 2022 Jul 19.
Guided by enhanced recovery after surgery protocols and coerced by constraints of the Coronavirus Disease 2019, the concept of same day discharge (SDD) after colon surgery is becoming a topic of great interest. Although only a few literature sources are published on the topic and protocols, the number of centers interested in SDD is increasing. With the small number of sources on protocol, safety, implementation, and criteria, there has yet to be a review of the patient experience and satisfaction.
Our institution has one of the largest American databases of SDD colon surgery. We performed a retrospective patient survey assessing perception of their surgical experience and satisfaction, which analyzed patients from February 2019 to January 2022. Fifty SDD patients were selected for participation, as well as fifty patients who were discharged on postoperative day 1 (POD1). An eleven-question survey was offered to patients and responses recorded.
One hundred patients were contacted, 50 SDD and 50 POD1. Of the SDD patients, 41/50 (82%) patients participated in the survey, while 23/50 (46%) of POD1 patients participated. The highest average response in both populations was an understanding of patient postoperative mobility instructions (9.27/10, 9.68/10). The lowest average response in the SDD population was family comfort with discharge (8.17/10), while patient comfort with discharge was lowest in the POD1 group, (8.56/10). Importantly, we observed that 85.37% of patients who underwent SDD would do so again if given the opportunity. The only statistically significant variable was a difference in comfort with postoperative pain control, favoring the POD1 group, p = 0.02.
SDD colon surgery is a feasible and reproducible option. Only comfort with postoperative pain control found a statistical difference, which we intend to improve upon with postanesthesia care unit education. Of patients reviewed who underwent SDD, most patients enjoyed their experience and would undergo SDD again.
在术后加速康复(ERAS)方案的指导下,并且受到 2019 年冠状病毒病(COVID-19)的限制,结肠手术后当天出院(SDD)的概念正成为一个热门话题。尽管关于该主题和方案的文献来源很少,但对 SDD 感兴趣的中心数量正在增加。由于方案、安全性、实施和标准方面的资源很少,因此还没有对患者的体验和满意度进行综述。
我们机构拥有美国最大的 SDD 结肠手术数据库之一。我们对患者的手术体验和满意度进行了回顾性患者调查,该调查分析了 2019 年 2 月至 2022 年 1 月的患者。选择了 50 名 SDD 患者和 50 名术后第 1 天(POD1)出院的患者参加调查。向患者提供了一份 11 个问题的调查问卷,并记录了他们的回答。
共联系了 100 名患者,其中 SDD 患者 50 名,POD1 患者 50 名。在 SDD 患者中,有 41/50(82%)名患者参与了调查,而 POD1 患者中有 23/50(46%)名患者参与了调查。在两个群体中,对患者术后活动能力的理解是平均得分最高的(9.27/10,9.68/10)。SDD 患者中,家属对出院的舒适度评分最低(8.17/10),而 POD1 患者中,患者对出院的舒适度评分最低(8.56/10)。重要的是,我们观察到,如果有机会,85.37%的 SDD 患者会再次选择 SDD。唯一具有统计学意义的变量是术后疼痛控制舒适度的差异,POD1 组的舒适度更高,p=0.02。
SDD 结肠手术是一种可行且可重复的选择。只有术后疼痛控制舒适度存在统计学差异,我们打算通过麻醉后护理病房的教育来改善这一点。在接受 SDD 的患者中,大多数患者对自己的体验感到满意,并愿意再次接受 SDD。