Zanon C, Deandrea M, Zan S, Giugno G, Sandrucci S, Trombetta F, Ballario R, Lenzo R, Mabiglia A, Mormile C
Cattedra di Metodologia Clinica Chirurgica, University of Turin, Italy.
Panminerva Med. 1995 Dec;37(4):207-9.
The development of surgery in regime of day hospital proceeds swiftly, especially in Anglo-saxon countries, so that at the beginning of the second millennium it can be foreseen that in USA alone, 75% of all surgery will be carried out in this manner. From March 1st to September 1st 1994, 100 patients were submitted to operations in ODS (One Day Surgery). We had 3 reconversions into ordinary hospitalization (3%), 2 for social-economic reasons and one for headache and vomiting due to intolerance to local anesthetics. As has been seen we have encountered no important complications, all patients were satisfied. From the analysis of our experience we have deducted useful indications that oblige us to partially modify our attitude: we want to transform our service into a free standing center where the patient can undergo preoperative exams, anesthesiologic examinations and surgery on the same day; we are just about to verify the possibility, thanks to an accurate anamnesis, to not request preoperative routine exams in patients with ASA 1 and 2 physical status; to look for a possible asymptomatic crural hernia in patients that undergo inguinal hernioplasty; we do not submit patients to ODS if they do not have assistance at home; or if they live too far from our service.
日间医院模式下外科手术的发展迅速，尤其是在盎格鲁 - 撒克逊国家，因此可以预见，在第二个千年伊始，仅在美国，所有外科手术的75% 将以这种方式进行。1994年3月1日至9月1日，100例患者接受了日间手术（ODS）。我们有3例转为普通住院（3%），2例是由于社会经济原因，1例是由于对局部麻醉不耐受导致头痛和呕吐。如所见，我们未遇到重大并发症，所有患者均满意。通过对我们经验的分析，我们得出了一些有用的指征，这些指征迫使我们部分改变态度：我们想将我们的服务转变为一个独立的中心，患者可以在同一天接受术前检查、麻醉检查和手术；我们即将验证，由于准确的问诊，对于ASA 1和2身体状况的患者不要求进行术前常规检查的可能性；在接受腹股沟疝修补术的患者中寻找可能无症状的股疝；如果患者在家中无人照料，或者居住离我们的服务机构太远，我们不将其纳入日间手术。
