Department of Hepatobiliary Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Institute of Hepatobiliary, Pancreatic and Intestinal Disease, North Sichuan Medical College, Nanchong, China.
Medicine (Baltimore). 2023 Feb 22;102(8):e32998. doi: 10.1097/MD.0000000000032998.
In China, laparoscopic inguinal hernia repair (LIHR) under the day surgery mode (DSM) has developed rapidly as an important surgical method for inguinal hernia repair, and it has unique advantages in many aspects. Compared with inpatient surgery mode (ISM), there are some differences in intraoperative and postoperative related indicators, hospitalization costs, and patient satisfaction. Many studies have shown that LIHR in DSM can significantly shorten hospital stay, effectively reduce hospitalization costs, and improve patient satisfaction. Accordingly, this study aimed to compare the differences in intraoperative and postoperative related indicators, hospitalization costs, and patient satisfaction of LIHR between DSM and ISM in China.
The PubMed/Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wan Fang databases were searched for randomized controlled trials, cohort studies from the establishment of the database to July 1, 2022. Odds ratio (OR), mean difference, standardized mean difference (SMD), and 95% confidence interval were selected as the effect scale indices for the evaluation of the difference in hospitalization costs, hospital stay, operation time, recovery time, complications, and patient satisfaction. All of these were compared using RevMan 5.3 Software (The Cochrane Collaboration, Copenhagen, Denmark).
Nine studies involving 1176 patients, 590 in the DSM group and 586 in the ISM group, were included. The hospital stay (d) (SMD = -7.27, 95% confidence interval, CI: -8.68 to -5.87, P < .001), hospitalization costs (SMD = -7.89, 95% CI: -10.25 to -5.53, P < .001) in DSM group were significantly lower than the ISM group. Additionally, the patient dissatisfaction (OR = 0.05, 95% CI: 0.01-0.17, P < .001) in DSM group was significantly lower than the ISM group. Nevertheless, no significant differences were found in the operation time (minute) (mean difference = -0.32, 95% CI: -1.78 to 1.14, P = .67), recovery time (h) (SMD = -3.27, 95% CI: -6.95 to 0.41, P = .08), and postoperative complications (OR = 0.80, 95% CI: 0.47-1.36, P = .41) between the 2 groups.
In China, compared with ISM, LIHR under DSM can significantly shorten hospital stay, greatly reduce hospitalization costs, and significantly improve patient satisfaction. There were no significant differences in operation time, recovery time and postoperative complications.
在中国，腹腔镜腹股沟疝修补术（LIHR）在日间手术模式（DSM）下作为腹股沟疝修补的重要手术方法发展迅速，在许多方面具有独特优势。与住院手术模式（ISM）相比，术中及术后相关指标、住院费用和患者满意度存在一定差异。许多研究表明，DSM 下的 LIHR 可显著缩短住院时间，有效降低住院费用，提高患者满意度。因此，本研究旨在比较中国 DSM 和 ISM 下 LIHR 术中及术后相关指标、住院费用和患者满意度的差异。
检索 PubMed/Medline、EMBASE、Cochrane 图书馆、中国知网和万方数据库，从数据库建立到 2022 年 7 月 1 日，收集 LIHR 用于 DSM 和 ISM 的随机对照试验和队列研究。选择比值比（OR）、均数差、标准化均数差（SMD）和 95%置信区间作为评估住院费用、住院时间、手术时间、恢复时间、并发症和患者满意度差异的效应尺度指标。使用 RevMan 5.3 软件（丹麦哥本哈根 Cochrane 协作网）对所有结果进行比较。
纳入 9 项研究共 1176 例患者，其中 DSM 组 590 例，ISM 组 586 例。DSM 组的住院时间（d）（SMD=-7.27，95%置信区间，CI：-8.68 至-5.87，P<0.001）和住院费用（SMD=-7.89，95%CI：-10.25 至-5.53，P<0.001）明显低于 ISM 组。此外，DSM 组患者的不满意率（OR=0.05，95%CI：0.01-0.17，P<0.001）明显低于 ISM 组。然而，两组间手术时间（分钟）（均数差=-0.32，95%CI：-1.78 至 1.14，P=0.67）、恢复时间（小时）（SMD=-3.27，95%CI：-6.95 至 0.41，P=0.08）和术后并发症（OR=0.80，95%CI：0.47-1.36，P=0.41）差异无统计学意义。
在中国，与 ISM 相比，DSM 下的 LIHR 可显著缩短住院时间，大幅降低住院费用，显著提高患者满意度。手术时间、恢复时间和术后并发症无显著差异。
