Voitk A J, Ignatius S, Schouten B D, Mustard R A
Department of Surgery, The Salvation Army Scarborough Grace Hospital, Toronto, Ontario, Canada.
J Gastrointest Surg. 1998 Mar-Apr;2(2):156-8. doi: 10.1016/s1091-255x(98)80007-3.
The trend toward outpatient surgery led to this study to determine the safety of elective outpatient laparoscopic surgery for the higher risk patient. One hundred consecutive higher risk patients from all patients scheduled for elective outpatient laparoscopic surgery were studied prospectively in a 256-bed community hospital. Seventeen percent of patients required admission. In each instance the need was readily evident in the perioperative observation period. Eighty-three percent of patients were stable and were successfully treated as outpatients. No patient who remained stable decompensated later, and none required readmission to treat complications resulting from outpatient status. The 2% readmission rate (for unrelated reasons) was comparable to the 2% readmission rate for low-risk patients. It was concluded that routine outpatient laparoscopic surgery is safe for elective higher risk patients. Problems requiring admission are readily evident during the period of observation and no patient who remains stable decompensates later.
门诊手术的趋势促使开展这项研究，以确定选择性门诊腹腔镜手术对高危患者的安全性。在一家拥有256张床位的社区医院，对连续100例计划接受选择性门诊腹腔镜手术的高危患者进行了前瞻性研究。17%的患者需要住院。在每种情况下，在围手术期观察期内需求都很明显。83%的患者情况稳定，作为门诊患者成功接受治疗。没有一名保持稳定的患者后来病情恶化，也没有患者因门诊状态导致的并发症而需要再次入院治疗。2%的再入院率（因无关原因）与低危患者2%的再入院率相当。得出的结论是，常规门诊腹腔镜手术对选择性高危患者是安全的。需要住院的问题在观察期内很明显，并且没有一名保持稳定的患者后来病情恶化。
