抄録
Objective: In an effort to shorten hospitalization days for laparoscopic adnexal surgery, various procedures were carried out both before and after the surgery.
Setting: We explained the laparoscopic procedure with a pamphlet. In addition, we streamlined the clinical path for efficiency and standardization of the treatment and nursing care. Operations were performed under total intravenous anesthesia; a transversus abdominis plane (TAP) block was used.
Patients: 191 patients who underwent laparoscopic adnexal surgery in our department from April 2007 through March 2010. Patients were requested to ambulate three hours after surgery and fed dinner on the day of surgery. Patients were discharged on the morning after surgery when possible and presented at the outpatient department one or two weeks later.. We compared 166 cases discharged the day after surgery to 25 other cases that were not discharged the day after surgery.
Results: The average hospital stay was 3.28 days. The average age of the patients with longer hospital stays was about 10 years older than the patients who were discharged on the first postoperative day. Surgery time, blood loss, and hospital costs were comparable. The main reasons for prolongation of the hospital stay were patient request, advanced age, and pain. Only four patients complained of difficulties after discharge.
Conclusions: Patients readily accept discharge on the day after surgery, if the process is explained to them before surgery. The main reasons for non-adherence to this policy are rare cases of advanced age or excessive blood loss.
