Clinical practice and safety evaluation of same-day surgery mode for inguinal hernia repair in elderly patients_West China Medical Journal

Authors：

QIN Lang ¹ , ZHAO Rui ² , WAN Qianyi ² , LIU Qian ¹ , HUANG Mingjun ¹ , DAI Yan ¹ , MA Hongsheng ¹ , LEI Wenzhang ² ,  SONG Yinghan ¹

1. Day Surgery Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

SONG Yinghan, Email: yinghan2222@163.com

Keywords：

Inguinal hernia repair; same-day surgery; the elderly; clinical practice; safety

DOI：

10.7507/1002-0179.202201001

Video：

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Objective To compare the postoperative outcomes of elderly and non-elderly patients undergoing inguinal hernia repair in same-day surgery mode, and explore the utility and safety of same-day surgery mode in inguinal hernia repair. Methods Patients who underwent inguinal hernia repair in Day Surgery Center, West China Hospital of Sichuan University between January 1st 2021 and October 31st 2021 were prospectively included. The patients were divided into elderly group (≥60 years old) and non-elderly group (18-59 years old). The preoperative conditions, postoperative outcomes, discharge readiness and social support of the two groups were analyzed. Results A total of 451 patients were enrolled, including 111 elderly patients and 340 non-elderly patients. The male proportion, prevalence rates of preoperative comorbidities, and bilateral inguinal hernia proportion in the elderly group were significantly higher than those in the non-elderly group (P<0.05), and the body mass index in the elderly group were significantly lower than that in the non-elderly group (P<0.05). There was no significant difference in anesthesia method, analgesic method, bleeding volume, or surgery time between the two groups (P>0.05). The postoperative pain score of the non-elderly group was higher than that in the elderly group (Z=–2.226, P=0.026), but there was no statistically significant difference in the rate of postoperative unplanned analgesia, rate of discharge delay, pain score on the third day after discharge, re-consultation within one month after discharge, complications within one month after discharge, or post-discharge satisfaction (P>0.05). The total score of social support was higher in the elderly group than that in the non-elderly group (31.77±3.04 vs. 29.75±4.78; t=4.182, P<0.001). Conclusion The same-day surgery mode for inguinal hernia repair is feasible and safe in elderly patients and worthy of implementation.

Citation： QIN Lang, ZHAO Rui, WAN Qianyi, LIU Qian, HUANG Mingjun, DAI Yan, MA Hongsheng, LEI Wenzhang, SONG Yinghan. Clinical practice and safety evaluation of same-day surgery mode for inguinal hernia repair in elderly patients. West China Medical Journal, 2023, 38(2): 201-205. doi: 10.7507/1002-0179.202201001 Copy

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15.	周義生, 丁焱, 朱承新, 等. 杭州市蕭山區成人腹股溝疝流行病學調查及對策. 中華疝和腹壁外科雜志(電子版), 2016, 10(5): 385-386.
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18.	冷遠洪, 胥蘭婷, 陳靜, 等. 日間手術患者出院準備度與出院指導質量相關性分析. 醫學信息, 2020, 33(21): 133-136.
19.	翟萌, 姜惠芬. 新冠病毒肺炎 COVID-19 的傳播途徑及預防和防護. 基因組學與應用生物學, 2020, 39(10): 4895-4898.
20.	馬鈺, 馬蒙蒙, 羅業飛, 等. 廣州市新型冠狀病毒肺炎密切接觸者感染危險因素分析. 中國公共衛生, 2020, 36(4): 507-511.
21.	黃迪, 黃子圣, 葉志東, 等. 新冠疫情影響下日間手術制度在乳腺外科住院模式中的應用與思. 廣州醫藥, 2022, 53(5): 29-32.

1. Ojo EO. Day case surgery and developing countries: a review. Niger J Clin Pract, 2010, 13(4): 459-466.
2. Mitchell M. Literature review: home recovery following day surgery. Ambulat Surg J, 2013, 19(1): 13-27.
3. Mitchell M. Home recovery following day surgery: a patient perspective. J Clin Nurs, 2015, 24(3/4): 415-427.
4. Pereira L, Figueiredo-Braga M, Carvalho IP. Preoperative anxiety in ambulatory surgery: the impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient Educ Couns, 2016, 99(5): 733-738.
5. 寧艷陽. 日間手術時間背后的質量角逐. 中國衛生, 2019(12): 86-88.
6. Fischer S, Zechmeister-Koss I. Is day surgery safe? A systematic literature review. Eur Surg, 2014, 46(3): 103-112.
7. 白雪, 馬洪升, 羅利. 中外日間手術發展對比研究及展望. 中國醫院管理, 2014, 34(5): 35-37.
8. 陳雙, 楊斌. 解讀歐洲疝學會的《成人腹股溝疝治療指南》. 外科理論與實踐, 2010, 15(6): 668-670.
9. 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.
10. 劉文雅, 魏文斌, 宋旭東, 等. 老年性白內障日間手術臨床路徑模式效果分析. 中國醫院管理, 2017, 37(9): 42-44.
11. 于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
12. 朱宏, 黃鴻燕, 鄭胄斌, 等. 日間手術的經濟學評價研究綜述. 衛生經濟研究, 2021, 38(9): 25-28, 32.
13. 劉洋, 馬洪升, 李志超, 等. 5520 例日間手術的安全和質量評價. 中國普外基礎與臨床雜志, 2015, 22(12): 1477-1481.
14. 雷甜甜, 梁鵬, 馬洪升, 等. 四川大學華西醫院日歸手術管理實踐. 廣東醫學, 2022, 43(10): 1222-1228.
15. 周義生, 丁焱, 朱承新, 等. 杭州市蕭山區成人腹股溝疝流行病學調查及對策. 中華疝和腹壁外科雜志(電子版), 2016, 10(5): 385-386.
16. 戴燕, 黃明君. 日間手術護理管理的實踐. 中國護理管理, 2021, 21(6): 951-956.
17. 劉洋, 張一敏, 王小成, 等. 四川大學華西醫院日間手術出院后管理規范. 華西醫學, 2019, 34(2): 137-139.
18. 冷遠洪, 胥蘭婷, 陳靜, 等. 日間手術患者出院準備度與出院指導質量相關性分析. 醫學信息, 2020, 33(21): 133-136.
19. 翟萌, 姜惠芬. 新冠病毒肺炎 COVID-19 的傳播途徑及預防和防護. 基因組學與應用生物學, 2020, 39(10): 4895-4898.
20. 馬鈺, 馬蒙蒙, 羅業飛, 等. 廣州市新型冠狀病毒肺炎密切接觸者感染危險因素分析. 中國公共衛生, 2020, 36(4): 507-511.
21. 黃迪, 黃子圣, 葉志東, 等. 新冠疫情影響下日間手術制度在乳腺外科住院模式中的應用與思. 廣州醫藥, 2022, 53(5): 29-32.

West China Medical Journal

Clinical practice and safety evaluation of same-day surgery mode for inguinal hernia repair in elderly patients

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