Department of General Surgery, Habib Thameur University Hospital, Tunis, Tunisia.
Department of Public Health and Epidemiology, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Pan Afr Med J. 2022 Jul 27;42:235. doi: 10.11604/pamj.2022.42.235.32863. eCollection 2022.
ambulatory surgery is continuously expanding in global reach because of its several advantages. This study aimed to describe the experience of our department in outpatient hernia surgery, evaluate its feasibility and safety, and determine the predictive factors for failure of this surgery.
we conducted a monocentric retrospective cohort study on patients who had ambulatory groin hernia repair (GHR) and ventral hernia repair (VHR) in the general surgery department of the Habib Thameur Hospital in Tunis between January 1, 2008 and December 31, 2016. Clinicodemographic characteristics and outcomes were compared between the successful discharge and discharge failure groups. A p-value of ≤ 0.05 was considered significant.
we collected data from the record of 1294 patients. One thousand and twenty patients had groin hernia repair (GHR). The failure rate of ambulatory management of GHR was 3.7%: 31 patients (3.0%) had unplanned admission (UA) and 7 patients (0.7%) had unplanned rehospitalization (UR). The morbidity rate was 2.4% while the mortality rate was 0%. On multivariate analysis, we did not identify any independent predictor of discharge failure in the GHR group. Two hundred and seventy-four patients underwent ventral hernia repair (VHR). The failure rate of ambulatory management of VHR was 5.5%: 11 patients (4.0%) had UA and 4 patients (1.5%) had UR. The morbidity rate was 3.6% and the mortality rate was zero. On multivariate analysis, we did not identify any variable predicting discharge failure.
our study data suggest that ambulatory hernia surgery is feasible and safe in well-selected patients. The development of this practice would allow for better management of eligible patients and would offer many economic and organizational advantages to healthcare structures.
由于其诸多优势，门诊手术在全球范围内不断扩展。本研究旨在描述我们科室在门诊疝修补术（GHR）和腹疝修补术（VHR）方面的经验，评估其可行性和安全性，并确定该手术失败的预测因素。
我们对 2008 年 1 月 1 日至 2016 年 12 月 31 日在突尼斯哈比卜·塔梅尔医院普外科接受门诊腹股沟疝修补术（GHR）和腹疝修补术（VHR）的患者进行了单中心回顾性队列研究。比较了成功出院组和出院失败组的临床人口统计学特征和结局。p 值≤0.05 为差异有统计学意义。
我们从 1294 名患者的病历中收集了数据。1020 名患者行腹股沟疝修补术（GHR）。门诊管理 GHR 失败率为 3.7%：31 例（3.0%）患者出现非计划入院（UA），7 例（0.7%）患者出现非计划再入院（UR）。发病率为 2.4%，死亡率为 0%。多因素分析显示，GHR 组无独立的出院失败预测因素。274 名患者行腹疝修补术（VHR）。门诊管理 VHR 失败率为 5.5%：11 例（4.0%）患者出现 UA，4 例（1.5%）患者出现 UR。发病率为 3.6%，死亡率为 0%。多因素分析显示，无变量预测出院失败。
我们的研究数据表明，门诊疝手术在选择合适的患者中是可行和安全的。开展这种实践将使符合条件的患者得到更好的管理，并为医疗结构带来许多经济和组织优势。
