McManus S A, Topp D A, Hopkins C
St. Peter's Medical Center, New Brunswick, New Jersey.
Am Surg. 1994 Dec;60(12):967-70.
This article outlines surgical, financial, and psychosocial advantages of outpatient, definitive breast cancer surgery. The analysis of 118 patients who underwent outpatient breast cancer surgery between January 1991 and December 1993--20 modified radical mastectomy, 90 lumpectomy and axillary dissection or axillary dissection alone, and 8 partial or simple mastectomy--revealed only three patients with minor complications requiring admission. Same-day discharge was safely accomplished by early morning admission and using recovery room time for postoperative education. Outpatient cost was $1572 compared with an average 3-day inpatient cost of $6282, for a potential savings of $4710, or 75%, per patient for modified radical mastectomy. Outpatient cost was $1080 compared with an average 2-day inpatient cost of $4907, for a potential savings of $3827, or 78%, per patient for lumpectomy with axillary node dissection. Patients have indicated a high level of satisfaction with ambulatory surgery and experienced faster healing and recovery at home within the family milieu.
本文概述了门诊乳腺癌根治性手术在外科、经济和心理社会方面的优势。对1991年1月至1993年12月期间接受门诊乳腺癌手术的118例患者进行分析——20例行改良根治性乳房切除术，90例行乳房肿瘤切除术及腋窝淋巴结清扫术或仅行腋窝淋巴结清扫术，8例行部分或单纯乳房切除术——结果显示仅有3例患者出现需要住院治疗的轻微并发症。通过清晨入院并利用恢复室时间进行术后教育，实现了当日出院。改良根治性乳房切除术的门诊费用为1572美元，而平均3天住院费用为6282美元，每位患者潜在节省4710美元，即75%。乳房肿瘤切除术加腋窝淋巴结清扫术的门诊费用为1080美元，而平均2天住院费用为4907美元，每位患者潜在节省3827美元，即78%。患者对门诊手术表示高度满意，并且在家中家庭环境中愈合和恢复得更快。
