Hattori Y, Uda H, Niu A, Yoshimura K, Sugawara Y
Department of Plastic Surgery, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Setagaya-ku, Tokyo, Japan.
Department of Plastic Surgery, Jichi Medical University, Shimotsuke, Tochigi, Japan; Lilla Craniofacial Clinic Tokyo, Chuo-ku, Tokyo, Japan.
Int J Oral Maxillofac Surg. 2023 Apr;52(4):476-480. doi: 10.1016/j.ijom.2022.08.015. Epub 2022 Sep 10.
The sagittal split ramus osteotomy (SSRO) has been performed mainly on an inpatient basis because of the duration of anaesthesia and the potential risk of postoperative complications, such as bleeding, pain, nausea, and vomiting. However, advances in both surgical and anaesthetic management have enabled the reduction of these risks and shortened the length of hospital stay. Thus, the SSRO may be feasible even in the ambulatory setting in elective cases. The clinical records of all patients who underwent an outpatient SSRO between August 2011 and September 2020 at Lilla Craniofacial Clinic were reviewed retrospectively. Data on age, sex, duration of surgery, operative procedures, intraoperative bleeding, and admission status were investigated. In total, 143 patients underwent a bilateral SSRO. The SSRO was performed as an isolated procedure in 73 patients and concomitantly with other surgical procedures in the remaining 70 patients. Overall, 142 of the 143 patients were discharged on the day of surgery (99.3%); only one (0.7%) required an overnight stay because of a submental haemorrhage after genioplasty. No emergency hospitalizations or readmissions occurred after discharge. Multimodal perioperative management, both surgical and anaesthetic, facilitated enhanced patient recovery after surgery, and SSRO was performed successfully and safely as an ambulatory procedure.
由于麻醉时间以及术后并发症（如出血、疼痛、恶心和呕吐）的潜在风险，下颌升支矢状劈开截骨术（SSRO）主要在住院患者中进行。然而，手术和麻醉管理方面的进展降低了这些风险，并缩短了住院时间。因此，在择期病例中，即使在门诊环境下进行SSRO也是可行的。回顾性分析了2011年8月至2020年9月在Lilla颅面诊所接受门诊SSRO的所有患者的临床记录。调查了患者的年龄、性别、手术时间、手术操作、术中出血情况和入院状态。共有143例患者接受了双侧SSRO。73例患者单独进行了SSRO，其余70例患者同时进行了其他外科手术。总体而言，143例患者中有142例在手术当天出院（99.3%）；只有1例（0.7%）因颏成形术后颏下出血需要过夜住院。出院后未发生紧急住院或再次入院情况。多模式围手术期管理，包括手术和麻醉管理，促进了患者术后的快速康复，SSRO作为门诊手术成功且安全地完成。
