Martel E, Bernard D, Tassé D, Wassef R
Département de Chirurgie, Université de Montréal, Hôpital Saint-Luc, Québec, Canada.
Ann Chir. 1996;50(8):589-92.
Because of the current economic situation, ambulatory surgery has become a "modus vivendi" for the surgeon. The aim of this study is to examine the feasibility of anal ambulatory surgery and the results obtained over a period of 12 months. 141 consecutive patients underwent anal surgery: 108 on an ambulatory basis (77%) and 33 were admitted to the hospital (23%). The reasons for admitting the patients were the complexity of the operation in 19 (8 sphincteroplasty, 5 complex fistulae, 3 recto-vaginal fistulae...) emergency procedures in 9 and miscellaneous reasons in 5 patients. All 108 patients operated on an ambulatory basis could be discharged at the end of the day but two, one for urinary retention and another because he underwent a more extensive procedure than first planned. Three more had urinary retention; they were catheterized and discharged on the same day. The four patients (3 women and 1 man) developed urinary retention following spinal anesthesia. Three patients (2.7%) had to come back to the emergency room in the first 24 hours for bleeding from the operative site. One of them had to be transfused and reoperated for hemostasis. In conclusion, ambulatory anal surgery is feasible in a large proportion of cases (77%) with a low rate of complications (7.4%) and low rate of unexpected hospital admission (2.7%). In a specialized colorectal unit, 23% of patients required hospitalization for a longer stay.
由于当前的经济形势,门诊手术已成为外科医生的一种“权宜之计”。本研究的目的是探讨肛门门诊手术的可行性以及在12个月期间所取得的结果。141例连续患者接受了肛门手术:108例为门诊手术(77%),33例住院治疗(23%)。患者住院的原因包括手术复杂(19例,其中8例括约肌成形术、5例复杂性肛瘘、3例直肠阴道瘘……)、急诊手术9例以及其他原因5例。所有108例接受门诊手术的患者在当天结束时均可出院,但有2例除外,1例因尿潴留,另1例因手术范围比原计划更广。另有3例发生尿潴留;对他们进行了导尿并于同日出院。这4例患者(3例女性和1例男性)在脊麻后发生尿潴留。3例患者(2.7%)在术后24小时内需返回急诊室处理手术部位出血。其中1例因出血需输血并再次手术止血。总之,大部分病例(77%)可行门诊肛门手术,并发症发生率低(7.4%),意外住院率低(2.7%)。在一个专门的结直肠科室,23%的患者需要住院更长时间。