Zhang Shuhao, Cai Duote, Jin Yi, Luo Wenjuan, Chen Qingjiang, Fan Xiaoyan, Gao Zhigang
Department Of General Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou, 310052, Zhejiang, China.
Updates Surg. 2025 Apr;77(2):575-582. doi: 10.1007/s13304-025-02141-0. Epub 2025 Mar 8.
The pediatric day surgery has experienced a rapid development in recent years. This study aims to investigate the prospects of day surgery in pediatric hospitals. A total of 17,549 pediatric patients with inguinal hernia (IH) treated between July 2018 and August 2023 were included. The patients were divided into four groups: group A1 (open IH repair [OIHR] in the traditional ward), A2 (laparoscopic IH repair [LIHR] in the traditional ward), B1 (OIHR in the day ward), and B2 (LIHR in the day ward). A retrospective analysis was conducted based on clinical data, satisfaction and prognosis. The present study showed that the operative time between groups A2 and B2 showed no significant difference (p = 0.1205). However, the total time from entering to exiting the operating room was significantly longer in group A2 compared to group B2 (p < 0.0001). Hospitalization costs were significantly lower for patients in the day ward compared to the traditional ward (p < 0.0001). There was no significant difference in the recurrent IH rate between groups A2 and B2 (p = 0.977) or in incision infection rates between the day and traditional wards. The recurrent IH rate was significantly higher after OIHR compared to LIHR (p < 0.0001). The parent satisfaction in the day ward is higher than the traditional ward. The day surgery model of LIHR is a safe, reliable, and economically beneficial surgical management model that is highly recommended for pediatric hospitals.
近年来,小儿日间手术发展迅速。本研究旨在探讨儿童医院日间手术的前景。纳入了2018年7月至2023年8月期间接受治疗的17549例小儿腹股沟疝(IH)患者。患者分为四组:A1组(传统病房开放腹股沟疝修补术[OIHR])、A2组(传统病房腹腔镜腹股沟疝修补术[LIHR])、B1组(日间病房OIHR)和B2组(日间病房LIHR)。基于临床数据、满意度和预后进行回顾性分析。本研究表明,A2组和B2组的手术时间无显著差异(p = 0.1205)。然而,A2组从进入手术室到离开手术室的总时间明显长于B2组(p < 0.0001)。与传统病房相比,日间病房患者的住院费用显著更低(p < 0.0001)。A2组和B2组之间的腹股沟疝复发率无显著差异(p = 0.977),日间病房和传统病房之间的切口感染率也无显著差异。与LIHR相比,OIHR后的腹股沟疝复发率显著更高(p < 0.0001)。日间病房家长的满意度高于传统病房。LIHR日间手术模式是一种安全、可靠且经济有益的手术管理模式,强烈推荐用于儿童医院。