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

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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.	刘洋, 马洪升, 叶辉. 日间腹腔镜胆囊切除术推广面临的问题与对策. 中华医院管理杂志, 2017, 33(5): 354-356.
2.	沈莺, 李洁菁, 张盈盈. CICARE 沟通模式在日间手术患者疼痛教育中的应用效果. 重庆医学, 2021, 50(7): 1254-1257.
3.	王萍, 陈程. 日间手术护患流程化沟通模式应用. 解放军医院管理杂志, 2021, 28(1): 82-85.
4.	蒋丽莎, 宋应寒, 马洪升. 中国日间手术未来发展愿景. 华西医学, 2021, 36(2): 141-143.
5.	杨周健, 刘钧, 陈曹婧, 等. 日间手术模式在小儿外科中的应用研究. 西南国防医药, 2020, 30(1): 18-21.
6.	何金辉, 杨晓丽, 顾倩, 等. 延续护理在日间手术中心腕管综合征患者术后护理中的应用效果. 解放军护理杂志, 2019, 36(5): 62-64, 76.
7.	雷甜甜, 宋应寒, 吕修和, 等. 集中管理模式下的消化道息肉日间手术管理实践. 中华医院管理杂志, 2020(2): 136-139.
8.	肖玮, 王天龙. 美国麻醉医师协会(2012)年会精读—日间手术及相关麻醉领域进展. 国际麻醉学与复苏杂志, 2013(10): 1673-4378.
9.	范雷, 戚敏杰, 张寒雪, 等. 成年居民不同血压水平与糖尿病患病风险相关性. 中华健康管理学杂志, 2022, 16(1): 15-20.
10.	马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
11.	邵珍珍, 朱琳, 唐文娟, 等. 儿童术后疼痛评估工具研究进展. 护理学杂志, 2021, 36(5): 102-108.
12.	王宁华. 疼痛定量评定的进展. 中国临床康复, 2002, 6(18): 2738-2739.
13.	王煜, 刘洋, 马洪升, 等. 乳腺微创旋切术日归手术模式在日间手术中心的临床应用. 华西医学, 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, 刘小南, 高博欣, 等. 计划性手术模式: 日间手术管理的新实践. 中国卫生质量管理, 2021, 28(7): 37-39, 47.
17.	冯伟, 汪启乐, 王盛, 等. 日间手术延期恢复模式下完全腹膜外与经腹腹膜前疝修补术在老年腹股沟疝中的应用. 腹腔镜外科杂志, 2021, 26(6): 426-429.
18.	杨真真, 贺馨, 端翔, 等. 日间手术模式在消化内科的实践与探索. 中华消化内镜杂志, 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. 刘洋, 马洪升, 叶辉. 日间腹腔镜胆囊切除术推广面临的问题与对策. 中华医院管理杂志, 2017, 33(5): 354-356.
2. 沈莺, 李洁菁, 张盈盈. CICARE 沟通模式在日间手术患者疼痛教育中的应用效果. 重庆医学, 2021, 50(7): 1254-1257.
3. 王萍, 陈程. 日间手术护患流程化沟通模式应用. 解放军医院管理杂志, 2021, 28(1): 82-85.
4. 蒋丽莎, 宋应寒, 马洪升. 中国日间手术未来发展愿景. 华西医学, 2021, 36(2): 141-143.
5. 杨周健, 刘钧, 陈曹婧, 等. 日间手术模式在小儿外科中的应用研究. 西南国防医药, 2020, 30(1): 18-21.
6. 何金辉, 杨晓丽, 顾倩, 等. 延续护理在日间手术中心腕管综合征患者术后护理中的应用效果. 解放军护理杂志, 2019, 36(5): 62-64, 76.
7. 雷甜甜, 宋应寒, 吕修和, 等. 集中管理模式下的消化道息肉日间手术管理实践. 中华医院管理杂志, 2020(2): 136-139.
8. 肖玮, 王天龙. 美国麻醉医师协会(2012)年会精读—日间手术及相关麻醉领域进展. 国际麻醉学与复苏杂志, 2013(10): 1673-4378.
9. 范雷, 戚敏杰, 张寒雪, 等. 成年居民不同血压水平与糖尿病患病风险相关性. 中华健康管理学杂志, 2022, 16(1): 15-20.
10. 马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复(ERAS)规范. 中国胸心血管外科临床杂志, 2016, 23(2): 104-106.
11. 邵珍珍, 朱琳, 唐文娟, 等. 儿童术后疼痛评估工具研究进展. 护理学杂志, 2021, 36(5): 102-108.
12. 王宁华. 疼痛定量评定的进展. 中国临床康复, 2002, 6(18): 2738-2739.
13. 王煜, 刘洋, 马洪升, 等. 乳腺微创旋切术日归手术模式在日间手术中心的临床应用. 华西医学, 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, 刘小南, 高博欣, 等. 计划性手术模式: 日间手术管理的新实践. 中国卫生质量管理, 2021, 28(7): 37-39, 47.
17. 冯伟, 汪启乐, 王盛, 等. 日间手术延期恢复模式下完全腹膜外与经腹腹膜前疝修补术在老年腹股沟疝中的应用. 腹腔镜外科杂志, 2021, 26(6): 426-429.
18. 杨真真, 贺馨, 端翔, 等. 日间手术模式在消化内科的实践与探索. 中华消化内镜杂志, 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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