Analysis of the application effect of same-day surgery mode in adult patients with inguinal hernia repair under enhanced recovery after surgery mode_West China Medical Journal

Authors：

LIU Qian ¹ , DAI Yan ² , LEI Tiantian ¹ , WANG Yu ¹ , ZHANG Suqing ¹ ,  HUANG Mingjun ²

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

Corresponding?author：

HUANG Mingjun, Email: huangmingjun@wchscu.cn

Keywords：

Enhanced recovery after surgery; same-day surgery; daytime surgery; inguinal hernia

DOI：

10.7507/1002-0179.202211122

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Objective To explore the application effect of same-day surgery mode in adult patients with inguinal hernia repair under enhanced recovery after surgery mode. Methods The perioperative data of adults undergoing inguinal hernia repair in the Day Surgery Center of West China Hospital, Sichuan University between August 2020 and March 2022 were analyzed retrospectively. The adult patients with inguinal hernia repair who received routine daytime surgery were taken as the control group (routine group), and the adult patients with inguinal hernia repair who received same-day surgery were selected as the trial group (same-day group). The differences in safety, cost and patient experience between the two groups were compared and analyzed. Results A total of 319 patients were included, including 152 in the routine group and 167 in the same-day group. There was no significant difference in gender, education level, occupation and hernia ring diameter between the two groups (P>0.05). The age of the patients in the same-day group was older than that in the routine group [(49.49±12.88) vs. (46.41±14.12) years, P<0.05]. The hernia position of the two groups was mostly on the right side, but there was a difference in the hernia position (P<0.05). In terms of safety indicators, the majority of patients in the two groups used local anesthesia. The proportion of local anesthesia (98.2% vs. 76.3%), the amount of intraoperative bleeding [2.8 (2.0, 5.0) vs. 1.3 (0.0, 5.0) mL] in the same-day group were higher than those in the routine group, and the operation time [25.2 (20.0, 33.0) vs. 32.3 (26.0, 40.7) min] in the same-day group was shorter than that in the routine group (P<0.05). There was no significant difference between the two groups in the time of getting out of bed and the complications rate on the 3rd and 28th days after operation (P>0.05). There were no intraoperative complications in both groups. In terms of cost indicators, there was no significant difference between the two groups in the hospitalization cost (P>0.05). The surgery cost of the same-day group was higher than that of the routine group [1472.0 (1438.1, 1614.6) vs. 1450.3 (1428.1, 1438.1) yuan, P<0.05]. The drug cost [109.2 (81.3, 138.7) vs. 255.8 (127.0, 261.6) yuan] and the total medical cost [8418.5 (8207.4, 9129.9) vs. 8912.1 (8325.9, 9177.9) yuan] in the same-day group were lower than those in the routine group (P<0.05). In terms of patient experience indicators, the postoperative pain score [0.3 (0.0, 1.0) vs. 0.2 (0.0, 0.0)] and satisfaction score [3.3 (3.0, 4.0) vs. 3.0 (3.0, 3.0)] of the same-day group were higher than those of the routine group (P<0.05). Conclusion Both the same-day surgery mode and the routine surgery mode of adult patients with inguinal hernia repair have high safety, but the same-day surgery mode is more economical and patient satisfaction is higher than the routine surgery mode, which suggest that the same-day surgery mode of adult patients with inguinal hernia repair under enhanced recovery after surgery mode is feasible, safe and economic, and further optimizes and improves the content and quality of daytime surgical medical services.

Citation： LIU Qian, DAI Yan, LEI Tiantian, WANG Yu, ZHANG Suqing, HUANG Mingjun. Analysis of the application effect of same-day surgery mode in adult patients with inguinal hernia repair under enhanced recovery after surgery mode. West China Medical Journal, 2023, 38(2): 196-200. doi: 10.7507/1002-0179.202211122 Copy

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3.	童貴顯, 劉同柱, 谷瑋. 我國日間疝修補術的應用現狀、效果及管理. 中國臨床研究, 2020, 33(9): 1271-1273.
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9.	李沛, 牛婭婷, 劉妍. 以 ERAS 理念為指導的鎮痛管理在改善腹腔鏡日間手術患者疼痛感及并發癥中的作用. 齊齊哈爾醫學院學報, 2022, 43(17): 1678-1681.
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12.	胡小忍, 安偉德, 徐雪東, 等. 日間手術模式下合理開展老年腹股溝疝 TAPP 安全性及可行性分析. 中華疝和腹壁外科雜志(電子版), 2020, 14(4): 403-407.
13.	劉冬華, 童鶯歌, 馮翠翠, 等. 4 種工具用于老年患者術后疼痛評估效果比較. 護理學雜志, 2018, 33(7): 1-4.
14.	孫振球, 徐勇勇. 醫學統計學. 北京: 人民衛生出版社, 2014: 457-492.
15.	楊曉宇, 王健, 孟彥, 等. 中國日間手術在探索中前行. 中國衛生經濟, 2020, 39(4): 19-22.
16.	孫輝, 明敏馨, 馬旭東. 我國二、三級醫療機構日間手術發展現狀分析. 中國醫院管理, 2022, 42(3): 48-51.
17.	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.
18.	Jiang L, Houston R, Li C, et al. Day surgery program at west china hospital: exploring the initial experience. Cureus, 2020, 12(7): e8961.
19.	詹麗莉, 劉洋, 蔣麗莎, 等. 日歸模式在日間手術的臨床應用與探討. 華西醫學, 2022, 37(2): 189-193.
20.	Sawhney M, Watt-Watson J, McGillion M. A pain education intervention for patients undergoing ambulatory inguinal hernia repair: a randomized controlled trial. Can J Nurs Res, 2017, 49(3): 108-117.
21.	吳佳男. 從“日間”到“日歸”: 精益手術更進一步. 中國醫院院長, 2021(18): 48-49.

1. 衛生經濟學會. 日間手術定義. (2022-04-25)[2023-01-26]. http://www.chinaasa.org/col.jsp?id=134.
2. 嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 2020, 40(2): 199-202.
3. 童貴顯, 劉同柱, 谷瑋. 我國日間疝修補術的應用現狀、效果及管理. 中國臨床研究, 2020, 33(9): 1271-1273.
4. Drissi F, Gillion JF, Duchalais E, et al. Readmissions at 30 days after inguinal hernia repair: a series of 5126 patients. J Visc Surg, 2021, 158(4): 299-304.
5. 蔣麗莎, 馬洪升. 日歸手術—中國日間手術的升華. 華西醫學, 2022, 37(2): 161-164.
6. Ansell GL, Montgomery JE. Outcome of ASA III patients undergoing day case surgery. Br J Anaesth, 2004, 92(1): 71-74.
7. 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.
8. 寧彩虹, BONSU ABDUL AZIZ, 黃耿文. 2018 版腹股溝疝國際指南解讀(日間手術部分). 中國普通外科雜志, 2019, 28(10): 1177-1180.
9. 李沛, 牛婭婷, 劉妍. 以 ERAS 理念為指導的鎮痛管理在改善腹腔鏡日間手術患者疼痛感及并發癥中的作用. 齊齊哈爾醫學院學報, 2022, 43(17): 1678-1681.
10. Massoumi RL, Crain N, Zhu C, et al. Postoperative physician phone calls as a method to decrease urgent care and emergency department returns after ambulatory general surgery. Am Surg, 2020, 86(10): 1373-1378.
11. 李為明, 許青文, 李奕俊, 等. 腹腔鏡腹股溝疝修補術日間手術模式的臨床效益評價. 中華疝和腹壁外科雜志(電子版), 2021, 15(1): 19-21.
12. 胡小忍, 安偉德, 徐雪東, 等. 日間手術模式下合理開展老年腹股溝疝 TAPP 安全性及可行性分析. 中華疝和腹壁外科雜志(電子版), 2020, 14(4): 403-407.
13. 劉冬華, 童鶯歌, 馮翠翠, 等. 4 種工具用于老年患者術后疼痛評估效果比較. 護理學雜志, 2018, 33(7): 1-4.
14. 孫振球, 徐勇勇. 醫學統計學. 北京: 人民衛生出版社, 2014: 457-492.
15. 楊曉宇, 王健, 孟彥, 等. 中國日間手術在探索中前行. 中國衛生經濟, 2020, 39(4): 19-22.
16. 孫輝, 明敏馨, 馬旭東. 我國二、三級醫療機構日間手術發展現狀分析. 中國醫院管理, 2022, 42(3): 48-51.
17. 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.
18. Jiang L, Houston R, Li C, et al. Day surgery program at west china hospital: exploring the initial experience. Cureus, 2020, 12(7): e8961.
19. 詹麗莉, 劉洋, 蔣麗莎, 等. 日歸模式在日間手術的臨床應用與探討. 華西醫學, 2022, 37(2): 189-193.
20. Sawhney M, Watt-Watson J, McGillion M. A pain education intervention for patients undergoing ambulatory inguinal hernia repair: a randomized controlled trial. Can J Nurs Res, 2017, 49(3): 108-117.
21. 吳佳男. 從“日間”到“日歸”: 精益手術更進一步. 中國醫院院長, 2021(18): 48-49.

West China Medical Journal

Analysis of the application effect of same-day surgery mode in adult patients with inguinal hernia repair under enhanced recovery after surgery mode

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