背景:英国日间手术协会认为甲状腺叶切除术是一种安全的日间手术。然而,目前,英国只有5.5%的甲状腺手术作为日间病例进行。我们确定是否以及如何在我们的中心安全地进行当天出院的甲状腺叶切除术。
方法:我们分析了2015年4月至2019年5月进行的所有甲状腺叶切除手术。排除标准包括完成手术,翻修手术,额外的程序和传播的疾病。结果以外科医生报告的并发症为基准,来自英国内分泌和甲状腺手术协会的第五次国家审计。此外,我们审查了我们医院目前使用的符合日间病例标准的患者人数,以确定该服务的可及性.
结果:总计,进行了259例甲状腺叶切除术,其中173例符合纳入标准。没有死亡,返回手术室疏散术后血肿或再次入院。术后有一个血肿在床边引流。173名患者中约有47名(27.2%)符合我们中心目前使用的日间病例标准。
结论:日间手术为提高床压提供了一种具有成本效益的解决方案,并且一致的方案可以优化患者的安全性和体验。
BACKGROUND: Thyroid lobectomy is considered to be a safe day
case procedure by the British Association of Day Surgery. However, currently only 5.5% of thyroid surgeries in the UK are undertaken as day cases. We determine if and how thyroid lobectomy with same-day discharge could safely be introduced in our centre.
METHODS: We analysed all thyroid lobectomy surgeries performed between April 2015 and May 2019. Exclusion criteria included completion surgery, revision surgery, additional procedures and disseminated disease. Outcomes were benchmarked against surgeon-reported complications from the British Association of Endocrine and Thyroid Surgery\'s 5th National Audit. Additionally, we reviewed the number of patients who met day
case criteria currently in use at our hospital to determine accessibility to the service.
RESULTS: In total, 259 thyroid lobectomy surgeries were undertaken and of these 173 met the inclusion criteria. There was no mortality, return to theatre for evacuation of postoperative haematoma or readmission. There was one postoperative haematoma which was drained at the bedside. Some 47 of the 173 (27.2%) patients met day
case criteria currently in use at our centre.
CONCLUSIONS: Day
case surgery provides a cost-effective solution to rising bed pressures and a coherent protocol can optimise patient safety and experience.