Hanna I T, Powrie S, Rose G E
Moorfields Eye Hospital, London.
Br J Ophthalmol. 1998 Apr;82(4):392-6. doi: 10.1136/bjo.82.4.392.
To assess the outcome, in terms of completion of admission and complication rates, for two series of patients undergoing open lacrimal surgery, one group planned for a day case admission and the other planned for inpatient stay.
A retrospective analysis of case notes was performed for 200 patients planned to have day case admission (for 209 open lacrimal operations) and the details compared with those for 200 inpatient admissions (for 228 lacrimal procedures) during the same period of study. The success rates for surgery were not examined.
9% of planned day cases required overnight admission, 5.5% for medical reasons and 3.5% for social or administrative reasons. There was a similar incidence of postoperative complications in planned day cases and inpatients, although 6% of day case patients developed postoperative cellulitis, compared with 1.3% of the inpatients (p = 0.01). Overall, the incidence of cellulitis was greater in cases complicated by intraoperative haemorrhage (p < 0.05) or the use of absorbable nasal packing (p < 0.0001). A similar number of patients in each group attended the accident and emergency department before the planned first postoperative clinic visit.
Patients undergoing open lacrimal surgery can be safely managed as day cases if carefully selected for suitability on social and medical criteria. The use of general anaesthesia is not, in itself, a contraindication to day case lacrimal surgery.
评估两组接受开放性泪囊手术患者的住院完成情况及并发症发生率,一组计划日间手术入院,另一组计划住院治疗。
对200例计划日间手术入院(共209例开放性泪囊手术)的患者病历进行回顾性分析,并将详细信息与同期200例住院患者(共228例泪囊手术)的病历进行比较。未考察手术成功率。
9%的计划日间手术患者需要过夜住院,其中5.5%是由于医疗原因,3.5%是由于社会或行政原因。计划日间手术患者和住院患者术后并发症发生率相似,不过6%的日间手术患者发生了术后蜂窝织炎,而住院患者的这一比例为1.3%(p = 0.01)。总体而言,术中出血(p < 0.05)或使用可吸收鼻腔填塞物(p < 0.0001)的病例中蜂窝织炎发生率更高。每组中在计划的首次术后门诊就诊前到急诊科就诊的患者数量相似。
如果根据社会和医学标准仔细筛选合适的患者,接受开放性泪囊手术的患者可以安全地作为日间手术进行管理。全身麻醉本身并非日间泪囊手术的禁忌证。