腹腔鏡手術において、退院時の診察を主治医が実施することで退院後の合併症は減少するか

抄録

Objective: This study aimed to determine whether the prognosis of the patients who underwent laparoscopic or robot-assisted surgery changes if the postoperative examination is performed by an attending or non-attending physician.

Methods: The medical records of 324 laparoscopic and robot-assisted surgeries performed at the hospital between January 1 and December 31, 2022, were reviewed retrospectively to determine the association between the physician who performed the postoperative examinations and post-discharge complications.

Results: The examinations were performed 2-3 days postoperatively by the attending physician in 281 cases (86％) and non-attending physician in 43 cases (14％). There were 23 post-discharge adverse events (7.1％). The adverse event rate were 18/281 (6.4％) and 5/43 (11％) in the attending and non-attending physician groups, respectively, with no significant differences (p＝0.231). Nineteen adverse events were judged to be surgery-related; 14/281 (4.9％) and 5/43 (11％) in the attending and non-attending physician groups, respectively, with no significant differences (p＝0.122). There were no post-discharge complications requiring re-hospitalization.

　Post-discharge complications were mostly grade 1 in the Clavien-Dindo classification, and none were grade ≥3. The incidence of post-discharge complications did not differ according to the physician who performed the examinations.

Conclusion: The results suggest that postoperative examinations may not necessarily have to be performed by the attending physician.