背景:迄今为止,没有研究调查面部女性化手术(FFS)作为门诊手术的安全性和结局.这是第一项基于并发症比较分析非卧床FFS结果的研究,术后急诊或紧急护理(ED/UC)就诊,入院时接受FFS的患者与当天手术的患者之间的再入院情况。
方法:对所有在单一综合医疗保健系统中接受FFS的患者进行回顾性分析。查看患者图表的手术细节,并发症,术后ED/UC访视,重新接纳,和人口因素。主要结果包括并发症,再入院,比较当天出院和术后住院组的ED/UC访视情况。
结果:在纳入研究的242名患者中,当天出院的患者(18.2%)和术后入院的患者(21.6%,p=0.52)。Logistic回归分析显示轻微并发症的复合结局无显著差异,主要并发症,和再入院(门诊15.6%,入院19.3%,p=0.46)。暂时性神经麻痹,感染,血肿是最常见的术后并发症。然而,下面部手术和手术时间的协变量显示在复合并发症结局方面有显著差异(分别为p=0.04和p=0.045).
结论:动态FFS是一种安全的做法,不会增加包括并发症在内的不良结局,ED/UC访问,与手术后入院相比,再入院。大量的性别保健中心应考虑采用当天的FFS,以可能受益于增加的日程安排灵活性和效率,增加获得护理的机会,降低医疗成本。
BACKGROUND: To date, there are no studies investigating the safety and outcomes of facial feminization surgery (FFS) as an outpatient procedure. This is the first study of its kind analyzing the outcomes of ambulatory FFS based on a comparison of complications, post-operative emergency department or urgent care (ED/UC) visits, and readmissions between patients who underwent FFS with admission versus same-day surgery.
METHODS: A retrospective analysis was conducted on all patients who underwent FFS in a single integrated healthcare system. Patient charts were reviewed for operative details, complications, post-operative ED/UC visits, readmission, and demographic factors. Major outcomes including complications, readmissions, and ED/UC visits were compared between groups with same-day discharge and post-operative hospital admission.
RESULTS: Of 242 patients included in the study, ED/UC visits were comparable between patients discharged same-day (18.2%) and patients admitted post-operatively (21.6%, p = 0.52). Logistic regression showed no significant difference in the composite outcomes of minor complications, major complications, and readmissions (15.6% for ambulatory versus 19.3% for admission, p = 0.46). Temporary nerve palsy, infection, and hematoma were the most common post-operative complications. However, covariates of a lower face procedure and operative time were shown to have significant differences in the composite complication outcome (p = 0.04 and p = 0.045, respectively).
CONCLUSIONS: Ambulatory FFS is a safe practice with no associated increase in adverse outcomes including complications, ED/UC visits, and readmission when compared to post-operative admission. Adoption of same-day FFS should be considered by high-volume gender health centers to potentially benefit from increased scheduling flexibility and efficiency, increased access to care, and lower healthcare costs.