Supervisor：Ministry of Education of the People's Republic of ChinaSponsor：Sichuan University Editor-in-chief：LUO Fengming Publishing period：
Monthly
ISSN：1002-0179CN：51-1356/R
Objective To summarize and explore the clinical management and practical effect of ambulatory hysteroscopic surgery.Methods The annual operation volume, disease types, three- and four-grade operation proportion, complications, hospitalization expenses, patient satisfaction and average length of hospital stay of patients undergoing ambulatory hysteroscopic surgery in the First Affiliated Hospital of Chongqing Medical University between September 2014 and August 2019 were retrospectively analyzed.Results A total of 5 446 patients underwent hysteroscopic surgery during the five-year period, of whom 569 cases underwent the operation in conventional hospitalization mode in the first year and 4 877 cases did in ambulatory mode in the following four years. The quantity of hysteroscopy operations increased by stages (P<0.001) and the structure of disease types was optimized. The proportion of three- and four-grade complex operations increased from 48.15% to 79.15% stage by stage in ambulatory mode (P<0.05); ambulatory hysteroscopic surgery was proved to be safe and controllable with a low incidence of complications [0.43% (21/4 877)]; the average hospitalization cost of the patients was significantly lower than that of the conventional hospitalization mode (P<0.05); the score of patient satisfaction increased from 92.90±1.77 to 94.57±2.11 compared with the conventional hospitalization mode, and increased further with the construction of the specialized platform to 96.19±2.24 (P<0.05); the average length of hospital stay in ambulatory mode was significantly shortened than that in conventional hospitalization mode (P<0.05).Conclusion Hysteroscopic surgery in ambulatory mode can improve the efficiency of medical services, ensure patient safety, improve patient satisfaction, reduce the average length of hospital stay, and reduce the economic burden of patients, so it could be widely promoted and standardized in clinical practice.
Citation：SHU Chunmei, CAO Chaoxia, ZHOU Qin. Clinical management practice of ambulatory hysteroscopic surgery. West China Medical Journal, 2021, 36(2): 195-200. doi: 10.7507/1002-0179.201912092Copy
Copyright ? the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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Wortman M, Daggett A, Ball C. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. J Minim Invasive Gynecol, 2013, 20(1): 56-63.
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Carabias P, Celades-Filella M, Zapardiel I, et al. Experience and results of office hysteroscopy at a primary hospital. J Obstet Gynaecol, 2014, 34(1): 54-56.
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Lee CE, Epp A. Safety and efficiency in a canadian outpatient gynaecological surgical centre. J Obstet Gynaecol Can, 2018, 40(4): 426-431.
9. Aydeniz B, Gruber IV, Schauf B, et al. A multicenter survey of complications associated with 21, 676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol, 2002, 104(2): 160-164.
10. Aas-Eng MK, Langebrekke A, Hudelist G. Complications in operative hysteroscopy-is prevention possible?. Acta Obstet Gynecol Scand, 2017, 96: 1399-1403.
11. Kayatas S, Meseci E, Tosun OA, et al. Experience of hysteroscopy indications and complications in 5, 474 cases. Clin Exp Obstet Gynecol, 2014, 41(4): 451-454.
12. Alexandroni H, Bahar R, Chill HH, et al. Reducing fluid-related complications during operative hysteroscopy: use of a new mandatory fluid-balance form. J Minim Invasive Gynecol, 2017, 24(6): 1014-1019.
13. Wortman M, Daggett A, Ball C. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. J Minim Invasive Gynecol, 2013, 20(1): 56-63.
14. Carabias P, Celades-Filella M, Zapardiel I, et al. Experience and results of office hysteroscopy at a primary hospital. J Obstet Gynaecol, 2014, 34(1): 54-56.
15. Lee CE, Epp A. Safety and efficiency in a canadian outpatient gynaecological surgical centre. J Obstet Gynaecol Can, 2018, 40(4): 426-431.
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Citation：SHU Chunmei, CAO Chaoxia, ZHOU Qin. Clinical management practice of ambulatory hysteroscopic surgery. West China Medical Journal, 2021, 36(2): 195-200. doi: 10.7507/1002-0179.201912092
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