Clinical application and discussion of same-day discharge in day surgery_West China Medical Journal

Authors：

ZHAN Lili ¹ , LIU Yang ² , JIANG Lisha ² , LI Lan ¹ , HUANG Mingjun ¹ , LIU Qian ¹ ,  DAI Yan ¹

1. Day Surgery Center, West China Hospital, Sichuan University / West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Day Surgery Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

Same-day surgery; day surgery; infantile hemangioma; inguinal herinia

DOI：

10.7507/1002-0179.202112133

Video：

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Objective To investigate the safety and effect of same-day discharge in injection sclerotherapy for children with hemangioma (IJCH) and tension-free hernioplasty for adults with inguinal herinia (TFHA). Methods A retrospective analysis was conducted on patients undergoing IJCH or TFHA in the Day Surgery Center of West China Hospital of Sichuan University between November 2020 and October 2021. According to the patient’s condition and willingness, they were divided into same-day discharge group (162 children and 180 adults) and overnight hospitalization group (68 children and 271 adults). The amount of intraoperative bleeding, length of hospital stay, hospitalization expenses, pain before discharge, and short-term postoperative complications were compared between the two groups. Visual analogue scale was used for pain assessment in adults and children over 6 years old, and smiley face score was used in children below 6 years old. Results Compared with those in the overnight discharge group, the amount of intraoperative bleeding in the same-day discharge group was less [IJCH: (0.45±0.05) vs. (2.76±1.21) mL, P<0.05; TFHA: (1.20±0.05) vs. (6.76±2.30) mL, P<0.05], length of hospital stay was shorter [IJCH: (7.99±1.22) vs. (23.10±1.42) h, P<0.05; TFHA: (6.13±1.79) vs. (22.75±1.80) h, P<0.05], hospitalization cost was lower [IJCH: (5094.00±1320.14) vs. (6263.52±1220.20) yuan, P<0.05; TFHA: (7199.21±1535.84) vs. (7976.82±1967.82) yuan, P<0.05], pain before discharge was milder (IJCH: 0.05±0.02 vs. 0.50±0.01, P<0.05; TFHA: 1.20±0.01 vs. 2.01±0.20, P<0.05). There was no significant difference in the incidence of postoperative complications or unplanned revisit within 30 days between the two modes (P>0.05). Conclusions The same-day surgery mode is safe and feasible in IJCH and TFHA, and can shorten the length of hospital stay and reduce the cost of hospitalization. It is suggested to popularize this mode in clinical practice.

Citation： ZHAN Lili, LIU Yang, JIANG Lisha, LI Lan, HUANG Mingjun, LIU Qian, DAI Yan. Clinical application and discussion of same-day discharge in day surgery. West China Medical Journal, 2022, 37(2): 189-193. doi: 10.7507/1002-0179.202112133 Copy

1.	劉洋, 馬洪升, 葉輝. 日間腹腔鏡膽囊切除術推廣面臨的問題與對策. 中華醫院管理雜志, 2017, 33(5): 354-356.
2.	沈鶯, 李潔菁, 張盈盈. CICARE 溝通模式在日間手術患者疼痛教育中的應用效果. 重慶醫學, 2021, 50(7): 1254-1257.
3.	王萍, 陳程. 日間手術護患流程化溝通模式應用. 解放軍醫院管理雜志, 2021, 28(1): 82-85.
4.	蔣麗莎, 宋應寒, 馬洪升. 中國日間手術未來發展愿景. 華西醫學, 2021, 36(2): 141-143.
5.	楊周健, 劉鈞, 陳曹婧, 等. 日間手術模式在小兒外科中的應用研究. 西南國防醫藥, 2020, 30(1): 18-21.
6.	何金輝, 楊曉麗, 顧倩, 等. 延續護理在日間手術中心腕管綜合征患者術后護理中的應用效果. 解放軍護理雜志, 2019, 36(5): 62-64, 76.
7.	雷甜甜, 宋應寒, 呂修和, 等. 集中管理模式下的消化道息肉日間手術管理實踐. 中華醫院管理雜志, 2020(2): 136-139.
8.	肖瑋, 王天龍. 美國麻醉醫師協會(2012)年會精讀—日間手術及相關麻醉領域進展. 國際麻醉學與復蘇雜志, 2013(10): 1673-4378.
9.	范雷, 戚敏杰, 張寒雪, 等. 成年居民不同血壓水平與糖尿病患病風險相關性. 中華健康管理學雜志, 2022, 16(1): 15-20.
10.	馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復(ERAS)規范. 中國胸心血管外科臨床雜志, 2016, 23(2): 104-106.
11.	邵珍珍, 朱琳, 唐文娟, 等. 兒童術后疼痛評估工具研究進展. 護理學雜志, 2021, 36(5): 102-108.
12.	王寧華. 疼痛定量評定的進展. 中國臨床康復, 2002, 6(18): 2738-2739.
13.	王煜, 劉洋, 馬洪升, 等. 乳腺微創旋切術日歸手術模式在日間手術中心的臨床應用. 華西醫學, 2021, 36(2): 178-182.
14.	Kenney PS, Nielsen PH, Modrau IS. Daytime-dependent cardioprotection in cardiac surgery: a large propensity-matched cohort study. Ann Thorac Surg, 2020, 110(5): 1629-1636.
15.	Tseng YW, Vedula SS, Malpani A, et al. Association between surgical trainee daytime sleepiness and intraoperative technical skill when performing septoplasty. JAMA Facial Plast Surg, 2019, 21(2): 104-109.
16.	俞德梁, 劉小南, 高博欣, 等. 計劃性手術模式: 日間手術管理的新實踐. 中國衛生質量管理, 2021, 28(7): 37-39, 47.
17.	馮偉, 汪啟樂, 王盛, 等. 日間手術延期恢復模式下完全腹膜外與經腹腹膜前疝修補術在老年腹股溝疝中的應用. 腹腔鏡外科雜志, 2021, 26(6): 426-429.
18.	楊真真, 賀馨, 端翔, 等. 日間手術模式在消化內科的實踐與探索. 中華消化內鏡雜志, 2020, 37(8): 545-547.
19.	Scarfe A, Duncan J, Ma N, et al. Day case hernia repair: weak evidence or practice gap?. ANZ J Surg, 2018, 88(6): 547-553.
20.	Sommerstein R, Marschall J, Kuster SP, et al. Cardiovascular daytime varying effect in cardiac surgery on surgical site infections and 1-year mortality: a prospective cohort study with 22, 305 patients. Infect Control Hosp Epidemiol, 2019, 40(6): 727-728.
21.	Korsholm M, Mogensen O, Jeppesen MM, et al. Systematic review of same-day discharge after minimally invasive hysterectomy. Int J Gynaecol Obstet, 2017, 136(2): 128-137.

1. 劉洋, 馬洪升, 葉輝. 日間腹腔鏡膽囊切除術推廣面臨的問題與對策. 中華醫院管理雜志, 2017, 33(5): 354-356.
2. 沈鶯, 李潔菁, 張盈盈. CICARE 溝通模式在日間手術患者疼痛教育中的應用效果. 重慶醫學, 2021, 50(7): 1254-1257.
3. 王萍, 陳程. 日間手術護患流程化溝通模式應用. 解放軍醫院管理雜志, 2021, 28(1): 82-85.
4. 蔣麗莎, 宋應寒, 馬洪升. 中國日間手術未來發展愿景. 華西醫學, 2021, 36(2): 141-143.
5. 楊周健, 劉鈞, 陳曹婧, 等. 日間手術模式在小兒外科中的應用研究. 西南國防醫藥, 2020, 30(1): 18-21.
6. 何金輝, 楊曉麗, 顧倩, 等. 延續護理在日間手術中心腕管綜合征患者術后護理中的應用效果. 解放軍護理雜志, 2019, 36(5): 62-64, 76.
7. 雷甜甜, 宋應寒, 呂修和, 等. 集中管理模式下的消化道息肉日間手術管理實踐. 中華醫院管理雜志, 2020(2): 136-139.
8. 肖瑋, 王天龍. 美國麻醉醫師協會(2012)年會精讀—日間手術及相關麻醉領域進展. 國際麻醉學與復蘇雜志, 2013(10): 1673-4378.
9. 范雷, 戚敏杰, 張寒雪, 等. 成年居民不同血壓水平與糖尿病患病風險相關性. 中華健康管理學雜志, 2022, 16(1): 15-20.
10. 馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復(ERAS)規范. 中國胸心血管外科臨床雜志, 2016, 23(2): 104-106.
11. 邵珍珍, 朱琳, 唐文娟, 等. 兒童術后疼痛評估工具研究進展. 護理學雜志, 2021, 36(5): 102-108.
12. 王寧華. 疼痛定量評定的進展. 中國臨床康復, 2002, 6(18): 2738-2739.
13. 王煜, 劉洋, 馬洪升, 等. 乳腺微創旋切術日歸手術模式在日間手術中心的臨床應用. 華西醫學, 2021, 36(2): 178-182.
14. Kenney PS, Nielsen PH, Modrau IS. Daytime-dependent cardioprotection in cardiac surgery: a large propensity-matched cohort study. Ann Thorac Surg, 2020, 110(5): 1629-1636.
15. Tseng YW, Vedula SS, Malpani A, et al. Association between surgical trainee daytime sleepiness and intraoperative technical skill when performing septoplasty. JAMA Facial Plast Surg, 2019, 21(2): 104-109.
16. 俞德梁, 劉小南, 高博欣, 等. 計劃性手術模式: 日間手術管理的新實踐. 中國衛生質量管理, 2021, 28(7): 37-39, 47.
17. 馮偉, 汪啟樂, 王盛, 等. 日間手術延期恢復模式下完全腹膜外與經腹腹膜前疝修補術在老年腹股溝疝中的應用. 腹腔鏡外科雜志, 2021, 26(6): 426-429.
18. 楊真真, 賀馨, 端翔, 等. 日間手術模式在消化內科的實踐與探索. 中華消化內鏡雜志, 2020, 37(8): 545-547.
19. Scarfe A, Duncan J, Ma N, et al. Day case hernia repair: weak evidence or practice gap?. ANZ J Surg, 2018, 88(6): 547-553.
20. Sommerstein R, Marschall J, Kuster SP, et al. Cardiovascular daytime varying effect in cardiac surgery on surgical site infections and 1-year mortality: a prospective cohort study with 22, 305 patients. Infect Control Hosp Epidemiol, 2019, 40(6): 727-728.
21. Korsholm M, Mogensen O, Jeppesen MM, et al. Systematic review of same-day discharge after minimally invasive hysterectomy. Int J Gynaecol Obstet, 2017, 136(2): 128-137.

West China Medical Journal

Clinical application and discussion of same-day discharge in day surgery

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