Department of Hepatobiliary and Upper Gastrointestinal Surgery, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
The Department of Surgery, St Vincent's Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
ANZ J Surg. 2022 Oct;92(10):2544-2550. doi: 10.1111/ans.18028. Epub 2022 Sep 7.
Telemedicine provides healthcare to patients at a distance from their treating clinician. There is a lack of high-quality evidence to support the safety and acceptability of telemedicine for postoperative outpatient follow-up. This randomized controlled trial-conducted before the COVID-19 pandemic-aimed to assess patient satisfaction and safety (as determined by readmission, reoperation and complication rates) by telephone compared to face-to-face follow-up after uncomplicated general surgical procedures.
Patients following laparoscopic appendicectomy or cholecystectomy and laparoscopic or open umbilical or inguinal hernia repairs were randomized to a telephone or face-to-face outpatient clinic. Patient demographics, perioperative details and postoperative outcomes were compared. Patient satisfaction was assessed via a standardized Likert-style scale.
One hundred and twenty-three patients were randomized over 12 months. Mean consultation times were significantly shorter for telemedicine than face-to-face clinics (telemedicine 10.52 ± 7.2 min, face-to-face 15.95 ± 9.96 min, P = 0.0021). There was no difference between groups in the attendance rates, nor the incidence or detection of postoperative complications. Of the 58 patients randomized to the telemedicine arm, 40% reported high, and 60% reported very high satisfaction with the method of clinic follow-up.
Telemedicine postoperative follow-up is safe and acceptable to patients and could be considered in patients undergoing uncomplicated benign general surgery.
远程医疗为远离治疗医生的患者提供医疗服务。目前缺乏高质量的证据来支持远程医疗在普通外科门诊随访中的安全性和可接受性。本项在 COVID-19 大流行之前进行的随机对照试验旨在评估通过电话进行的普通外科手术后门诊随访与面对面随访相比的患者满意度和安全性（通过再入院率、再次手术率和并发症发生率来确定）。
接受腹腔镜阑尾切除术或胆囊切除术以及腹腔镜或开放式脐疝或腹股沟疝修补术的患者被随机分配到电话或面对面门诊。比较患者的人口统计学、围手术期细节和术后结果。通过标准化李克特量表评估患者满意度。
在 12 个月期间，对 123 名患者进行了随机分组。远程医疗的平均咨询时间明显短于面对面诊所（远程医疗 10.52 ± 7.2 分钟，面对面 15.95 ± 9.96 分钟，P = 0.0021）。两组的就诊率、术后并发症的发生率或检出率均无差异。在被分配到远程医疗组的 58 名患者中，40%报告对该种门诊随访方式非常满意，60%报告高度满意。
远程医疗术后随访对患者来说是安全且可接受的，可考虑用于接受简单良性普通外科手术的患者。
