Analysis of the disease entities and typical characteristics of day surgery based on three Public Tertiary A hospitals in China

Background:In recent years,day surgery has gained widespread attention in the medical industry.This thesis focuses on three tertiary general hospitals in different regions in China where day surgery has been carried out earlier,is more developed,has a more comprehensive range of day surgery procedures,and has an annual volume of 10,000 or more day surgery cases.The study will provide hands-on experience for other medical institutions to carry out day surgery.Methods:67,337 valid items of data were retrieved from the Hospital Information Systems of the three hospitals.In this thesis,descriptive analysis was carried out on basic information about day surgery patients,including composition of patients’major diseases,hospitalization costs.Non-parametric tests were used to compare the data in each group,the median and interquartile range were used to show the trend in the concentration of the relevant indicators.The difference was considered statistically significant at P<0.05.Results:The largest proportion of day surgery patients were between the ages of 51 and 70.About 57.30%of day surgery patients paid for their medical care with the basic medical insurance of urban employees.Senile cataract,benign breast tumor,and endometrial polyp were the top three major diagnoses of day surgery patients.The average inpatient expenditure for day surgery patients was 8982.10 yuan,with consumables cost representing the highest proportion at approximately 46.01%of the total hospitalization cost,followed by treatment cost at around 31.01%of the total cost.Conclusions:Day surgery is more suitable for middle-aged patients and may not be the best choice for children and elderly patients over 80 years old.Most day surgery cases are elective surgeries for non-emergency situations.The distribution of day surgery patients is primarily concentrated in ophthalmic,breast,and reproductive system diseases,although each hospital has its own unique characteristics.The development of day surgery presents both economic and social benefits.

Application of Whole-Process Management in Day Surgery for Endometrial Polyp

Objective:To explore the effect of whole-process management model in nursing management of endometrial polyp day surgery.Methods:266 patients that underwent endometrial polyp day surgery from January to December 2022 were selected for this study,and they were separated into an observation group(131 patients)and a control group(135 patients);the clinical data of the two groups were compared.Results:After intervention,the scores of Hamilton Anxiety Scale(HAM-A)of the patients in the observation group were lower than those in the control group(P<0.05).The rate of postoperative complications in the observation group was lower than that in the control group(P<0.05),and the satisfaction degree of the patients in the observation group was higher than that in the control group(P<0.05).Conclusion:The application of the whole-course management model in endometrial polyp day surgery can alleviate patients’anxiety,ensure the quality and safety of day surgery nursing,and improve patients’satisfaction.

Nursing Care of 13 Cases with Acute Retinal Necrosis Associated with HIV/AIDS during Day Surgery

Objective: Summarizing the nursing points from the treatment of the 13 cases of AIDS-related acute retinal necrosis syndrome (ARNS). Methods: Retrospective analysis of clinical nursing process of 13 cases (15 eyes) of AIDS-related ARNS patient treated in our hospital from January to December 2019. Results: The retina of all the patients were flat after operation. Postoperative visual acuity: bilateral visual acuity < 0.05 in 3 cases, >0.1 in 11 eyes, 0.01 - 0.1 in 3 eyes, >0.1 in 1 eye. No adverse events and nursing safety events occurred. Patients recovered well after operation during the follow-up after discharge. Conclusion: The focus of nursing care for patients with HIV/AIDS combined with acute retinal necrosis during daytime surgery is multifaceted, apart from the daily, perioperative nursing in day-care unit, continuous nursing, psychological counseling, disinfection and isolation should be paid attention to. At the same time, with the help of promotion and application of information education means, the treatment compliance of patients can be improved, which plays an essential role in the advance of the treatment effect.

Day surgery in strabismus operation under general anesthesia

Background:The purpose of this study is to summarize the application of day surgery combined with fast track program in strabismus operation under general anesthesia.Methods:The clinical data of 2,000 cases of strabismus patients who had underwent surgery in day surgery or traditional hospitalization in the duration from 2015 to 2016 was retrospectively analyzed.The safety and efficacy were assessed by comparing the average length of stay in hospitals,anesthesia recovery time,patient satisfaction and number of adverse events.Results:Compared with the traditional group,the average length of stay in hospital and recovery time in day surgery group were significantly lower(P<0.001)and the satisfaction of patient was improved(P<0.05),which were statistically significant difference.Moreover,no adverse events occurred among these patients.Conclusions:The application of day surgery in strabismus operation under general anesthesia is feasible,which can reduce the recovery time and shorten the hospital stay of patients safely and effectively,and their satisfaction was improved at the same time.

VAB and MRI Following Percutaneous Ultra-Sound Guided Cryoablation for Primary Early-Stage Breast Cancer: A Pilot Study in Japan

Objective: This study aimed to evaluate the feasibility, safety, and cosmetic outcomes of percutaneous cryoablation (PCA) of breast intraductal carcinoma (IDC) lesions, as well as post-cryoablation magnetic resonance imaging (MRI) as a follow-up tool for detection of residual malignancies and local recurrences. Methods: Eight female patients underwent percutaneous ultrasound-guided cryoablation of breast IDC tumors under local anesthesia without subsequent resection. All patients received radiation- and endocrine therapies (RT, ET). The patients were followed using vacuum-assisted biopsy (VAB), mammography (MG), magnetic resonance imaging (MRI), and Moiré Topography for cosmetic outcomes. VAB was performed 6 months following cryoablation treatment for cases 1 and 2 (after starting radiation- and endocrine-therapies) or one month after PCA (cases 3, 4, 5, 6 and 7), prior to RT and ET. One patient declined VAB. Results: Mean age of the patients was 61.9 years, SD 7.7, ages range 53 - 72 years. Mean tumor size was 10.3 mm, SD 2.74, ranged 6.8 - 14.5 mm, median follow-up time was 28 months (range 13 - 34 months). No residual or recurrent malignancies were detected. One minor adverse event was observed: A skin redness in the ablated area;MRI at one-month post-cryotherapy showed various degrees of thermal burns in all patients in the pectoralis major muscle, which were not symptomatic and were resolved by 6 months following PCA. Decrease of fat necrosis areas in the vicinity of ablated ex-tumor was traced with MRI (mean size 54.9 mm, mean decrease after 2 years was 58%) and validated with VAB. Conclusions: Percutaneous cryoablation of early-stage low-risk breast cancer tumors smaller than 15 mm potentially presents a potential substitute for lumpectomy, offering encouraging short- to mid-term oncology results with good cosmesis outcomes. Patients would be able to benefit from local anesthesia in an outpatient setting and a shorter recovery period.