Bulletin of Shimane University Faculty of Medicine

number of downloads : ?
Bulletin of Shimane University Faculty of Medicine 40
2018-03-31 発行

当院で行っている日帰り手術と1泊2日入院手術の圏域別比較 -地域のニーズに合わせた診療体制の構築-

Day and Short Stay Surgery for Infants and Children Tailored to Local Endemism Within Shimane
Nakada, Soichi Department of Digestive and General Surgery
Kumori, Kouji Department of Digestive and General Surgery
Ota, yoko Department of Digestive and General Surgery
Ishibashi, Syuichi Department of Digestive and General Surgery
Okano, Shinji Department of Digestive and General Surgery
File
Description
We have established a day and short stay surgery pathway for infants and children,
which is tailored to the local endemism within Shimane. The gists of this system are as follows:
1 )we pediatric surgeons visit local hospitals and provide outpatient services; 2 )the patients are
allowed to choose either day surgery(DS)or short stay surgery(SS), depending on their wishes
and living environment; and 3 )we provide a close postoperative follow-up process in coorperation
with local hospitals. In the present study, we reviewed the outcomes of 642 patients who underwent
pediatric surgery on this perioperative pathway. The DS and SS groups included 473 and 169 patients,
respectively. The patients who live around our hospital tended to choose DS, while patients who live
in rural areas wished to receive SS. Only a few patients, 11(2%)cases with DS and 7(4%)with
SS, showed a delayed discharge from the hospital for some reasons and the perioperative pathway
was confirmed to be safe. In performing minimally invasive pediatric surgeries, our perioperative
management system combined with "day surgery" and "short stay surgery" could provide a safe
surgical support with a high satisfaction for most patients in Shimane.
当院小児外科では、地域のニーズに合わせた診療として「日帰り手術」「1泊2日入院
手術」「小児外科専門の出張外来」を行っている。1泊2日入院手術は、術前検査と麻酔科受診を
入院当日に行い、翌日に手術・退院とするもので、小児外科専門の出張外来で診察を行った遠方
の患者を主体に、希望に応じて行っている。今回、これらの体制を構築した2009 年5月から5年
間に施行した日帰り手術(DS群)と1泊2日入院手術(SS群)の安全性と地域との関連を後方視
的に検討した。DS群473例、SS群169例で、DS群は病院近隣患者が多く、SS群は遠方患者が多かっ
た。種々の理由で退院延期となった症例はDS群11 例(2%)、SS群7例(4%)と僅かであった。
日帰り手術、1泊2日入院手術ともに安全に施行でき、遠方からの来院に配慮した1泊2日入院
手術を併施することで、地域のニーズに合わせた医療を提供できると考えられた。
DOI(SelfDOI)
Rights
島根大学医学部