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住院手术与门诊手术修复唇裂的比较:多位外科医生的经验

Cleft Lip Repair Comparison Between Inpatient and Outpatient Surgeries: A Multi-Surgeon Experience.

作者信息

Howell Haven M, Galarza Laura I, Humphries Laura S, Hoppe Ian C

机构信息

University of Mississippi School of Medicine, Jackson, MS, USA.

Stephanie and Mitchell Morris Center for Cleft and Craniofacial Research and Innovation, Division of Plastic and Reconstructive Surgery, Children's of Mississippi, Jackson, MS, USA.

出版信息

Cleft Palate Craniofac J. 2025 Nov;62(11):1861-1864. doi: 10.1177/10556656241278569. Epub 2024 Aug 28.

DOI:10.1177/10556656241278569
PMID:39196655
Abstract

ObjectiveGreat variability exists as to whether cleft lip (CL) repair is performed as an inpatient or outpatient surgery. This study's aim is to investigate the authors' institutional experience to see if there is an increase in complications, emergency department (ED) visits, or readmissions to the hospital when performed as outpatient.DesignThis study reviewed patients who underwent CL repair between 2012 and 2023 at the authors' institution. Data collected included patient demographics, perioperative details, ED visits and readmissions within thirty days of surgery, and complications.ResultsOne hundred forty-five patients met inclusion measures. When the surgery was performed as outpatient, there was no significant difference in returning to the ED (p = 0.767) or readmission to the hospital (p = 0.447) within thirty days as compared to inpatient surgeries. Outpatients did not have more postoperative complications (p = 0.698). Bilateral cleft lips were more likely to be performed as inpatient (p = 0.001). Inpatients had a lower weight at time of repair (p = 0.033). Patients with a respiratory (p = .006), gastrointestinal (p = 0.003), or hematologic (p = 0.013) comorbidity had a higher readmission rate. Patients were more likely to be readmitted if they had a younger gestational age (p = 0.005).ConclusionThere was no increased return to the ED or readmission for patients undergoing inpatient versus outpatient CL repair. CL repair can be performed safely in an outpatient setting with careful patient selection.

摘要

目的

唇裂修复手术是作为住院手术还是门诊手术进行,存在很大差异。本研究的目的是调查作者所在机构的经验,以确定唇裂修复手术作为门诊手术进行时,并发症、急诊就诊或再次入院情况是否会增加。

设计

本研究回顾了2012年至2023年在作者所在机构接受唇裂修复手术的患者。收集的数据包括患者人口统计学信息、围手术期细节、术后30天内的急诊就诊和再次入院情况以及并发症。

结果

145名患者符合纳入标准。与住院手术相比,唇裂修复手术作为门诊手术进行时,术后30天内返回急诊室(p = 0.767)或再次入院(p = 0.447)没有显著差异。门诊患者术后并发症并不更多(p = 0.698)。双侧唇裂更有可能作为住院手术进行(p = 0.001)。住院患者修复时体重较低(p = 0.033)。患有呼吸系统(p = 0.006)、胃肠道(p = 0.003)或血液系统(p = 0.013)合并症的患者再次入院率较高。如果患者孕周较小,则更有可能再次入院(p = 0.005)。

结论

唇裂修复手术住院患者与门诊患者相比,返回急诊室或再次入院的情况没有增加。通过仔细选择患者,唇裂修复手术可以在门诊环境中安全进行。

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