Clinical management practice of ambulatory hysteroscopic surgery_West China Medical Journal

Authors：

SHU Chunmei , CAO Chaoxia ,  ZHOU Qin

Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P. R. China;

Corresponding author：

ZHOU Qin, Email: zhqinou@163.com

Keywords：

Ambulatory surgery; Hysteroscopic surgery; Clinical management practice

DOI：

10.7507/1002-0179.201912092

Video：

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Objective To summarize and explore the clinical management and practical effect of ambulatory hysteroscopic surgery.Methods The annual operation volume, disease types, three- and four-grade operation proportion, complications, hospitalization expenses, patient satisfaction and average length of hospital stay of patients undergoing ambulatory hysteroscopic surgery in the First Affiliated Hospital of Chongqing Medical University between September 2014 and August 2019 were retrospectively analyzed.Results A total of 5 446 patients underwent hysteroscopic surgery during the five-year period, of whom 569 cases underwent the operation in conventional hospitalization mode in the first year and 4 877 cases did in ambulatory mode in the following four years. The quantity of hysteroscopy operations increased by stages (P<0.001) and the structure of disease types was optimized. The proportion of three- and four-grade complex operations increased from 48.15% to 79.15% stage by stage in ambulatory mode (P<0.05); ambulatory hysteroscopic surgery was proved to be safe and controllable with a low incidence of complications [0.43% (21/4 877)]; the average hospitalization cost of the patients was significantly lower than that of the conventional hospitalization mode (P<0.05); the score of patient satisfaction increased from 92.90±1.77 to 94.57±2.11 compared with the conventional hospitalization mode, and increased further with the construction of the specialized platform to 96.19±2.24 (P<0.05); the average length of hospital stay in ambulatory mode was significantly shortened than that in conventional hospitalization mode (P<0.05).Conclusion Hysteroscopic surgery in ambulatory mode can improve the efficiency of medical services, ensure patient safety, improve patient satisfaction, reduce the average length of hospital stay, and reduce the economic burden of patients, so it could be widely promoted and standardized in clinical practice.

Citation： SHU Chunmei, CAO Chaoxia, ZHOU Qin. Clinical management practice of ambulatory hysteroscopic surgery. West China Medical Journal, 2021, 36(2): 195-200. doi: 10.7507/1002-0179.201912092 Copy

1.	徐乐, 徐欣怡, 史兆荣. 日间手术相关研究热点的共词聚类分析. 东南国防医药, 2019, 21(4): 435-437.
2.	夏恩兰. 宫腔镜手术并发症的过往及现状. 中华妇幼临床医学杂志(电子版), 2016, 12(3): 249-254.
3.	中华医学会妇产科学分会计划生育学组. 剖宫产术后子宫瘢痕妊娠诊治专家共识(2016). 中华妇产科杂志, 2016, 51(8): 568-572.
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5.	赖婷, 唐建军, 徐春佳, 等. 10年宫腔镜手术并发症31例分析. 中国内镜杂志, 2014, 20(3): 261-264.
6.	夏恩兰. 宫腔镜手术并发症诊治现状及展望. 中国实用妇科与产科杂志, 2015, 31(5): 369-373.
7.	戴士媛, 顾心月, 徐爱军. 住院患者医疗服务满意度及影响因素分析——基于江苏省第六次卫生服务调查数据. 卫生经济研究, 2019, 36(11): 41-43.
8.	陈吟, 孙静, 刘远立. 中国妇幼医疗机构住院患者总体满意度影响因素多水平线性模型分析. 中国公共卫生, 2018, 34(11): 1501-1505.
9.	Aydeniz B, Gruber IV, Schauf B, et al. A multicenter survey of complications associated with 21, 676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol, 2002, 104(2): 160-164.
10.	Aas-Eng MK, Langebrekke A, Hudelist G. Complications in operative hysteroscopy-is prevention possible?. Acta Obstet Gynecol Scand, 2017, 96: 1399-1403.
11.	Kayatas S, Meseci E, Tosun OA, et al. Experience of hysteroscopy indications and complications in 5, 474 cases. Clin Exp Obstet Gynecol, 2014, 41(4): 451-454.
12.	Alexandroni H, Bahar R, Chill HH, et al. Reducing fluid-related complications during operative hysteroscopy: use of a new mandatory fluid-balance form. J Minim Invasive Gynecol, 2017, 24(6): 1014-1019.
13.	Wortman M, Daggett A, Ball C. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. J Minim Invasive Gynecol, 2013, 20(1): 56-63.
14.	Carabias P, Celades-Filella M, Zapardiel I, et al. Experience and results of office hysteroscopy at a primary hospital. J Obstet Gynaecol, 2014, 34(1): 54-56.
15.	Lee CE, Epp A. Safety and efficiency in a canadian outpatient gynaecological surgical centre. J Obstet Gynaecol Can, 2018, 40(4): 426-431.
16.	邵新华, 方朕, 杨炯, 等. 关于开展日间手术的实践和探讨. 中国医院, 2010, 14(12): 36-38.
17.	石天晓, 顾潇怡, 于海峰, 等. 国内日间手术实践成效与推广建议. 现代医院管理, 2017, 15 (6): 46-48.
18.	贺晓烨, 王莹, 李得保, 等. 新疆某三甲医院肿瘤日间病房运行效果. 解放军医院管理杂志, 2017, 24(2): 167-169.
19.	赵延慧, 唐楠, 韩琳, 等. 国内外日间手术患者延续性护理研究进展. 护理学报, 2018, 25(6): 24-27.

1. 徐乐, 徐欣怡, 史兆荣. 日间手术相关研究热点的共词聚类分析. 东南国防医药, 2019, 21(4): 435-437.
2. 夏恩兰. 宫腔镜手术并发症的过往及现状. 中华妇幼临床医学杂志(电子版), 2016, 12(3): 249-254.
3. 中华医学会妇产科学分会计划生育学组. 剖宫产术后子宫瘢痕妊娠诊治专家共识(2016). 中华妇产科杂志, 2016, 51(8): 568-572.
4. 中华医学会妇产科学分会妇科内镜学组. 妇科宫腔镜诊治规范. 中华妇产科杂志, 2012, 47(7): 555-558.
5. 赖婷, 唐建军, 徐春佳, 等. 10年宫腔镜手术并发症31例分析. 中国内镜杂志, 2014, 20(3): 261-264.
6. 夏恩兰. 宫腔镜手术并发症诊治现状及展望. 中国实用妇科与产科杂志, 2015, 31(5): 369-373.
7. 戴士媛, 顾心月, 徐爱军. 住院患者医疗服务满意度及影响因素分析——基于江苏省第六次卫生服务调查数据. 卫生经济研究, 2019, 36(11): 41-43.
8. 陈吟, 孙静, 刘远立. 中国妇幼医疗机构住院患者总体满意度影响因素多水平线性模型分析. 中国公共卫生, 2018, 34(11): 1501-1505.
9. Aydeniz B, Gruber IV, Schauf B, et al. A multicenter survey of complications associated with 21, 676 operative hysteroscopies. Eur J Obstet Gynecol Reprod Biol, 2002, 104(2): 160-164.
10. Aas-Eng MK, Langebrekke A, Hudelist G. Complications in operative hysteroscopy-is prevention possible?. Acta Obstet Gynecol Scand, 2017, 96: 1399-1403.
11. Kayatas S, Meseci E, Tosun OA, et al. Experience of hysteroscopy indications and complications in 5, 474 cases. Clin Exp Obstet Gynecol, 2014, 41(4): 451-454.
12. Alexandroni H, Bahar R, Chill HH, et al. Reducing fluid-related complications during operative hysteroscopy: use of a new mandatory fluid-balance form. J Minim Invasive Gynecol, 2017, 24(6): 1014-1019.
13. Wortman M, Daggett A, Ball C. Operative hysteroscopy in an office-based surgical setting: review of patient safety and satisfaction in 414 cases. J Minim Invasive Gynecol, 2013, 20(1): 56-63.
14. Carabias P, Celades-Filella M, Zapardiel I, et al. Experience and results of office hysteroscopy at a primary hospital. J Obstet Gynaecol, 2014, 34(1): 54-56.
15. Lee CE, Epp A. Safety and efficiency in a canadian outpatient gynaecological surgical centre. J Obstet Gynaecol Can, 2018, 40(4): 426-431.
16. 邵新华, 方朕, 杨炯, 等. 关于开展日间手术的实践和探讨. 中国医院, 2010, 14(12): 36-38.
17. 石天晓, 顾潇怡, 于海峰, 等. 国内日间手术实践成效与推广建议. 现代医院管理, 2017, 15 (6): 46-48.
18. 贺晓烨, 王莹, 李得保, 等. 新疆某三甲医院肿瘤日间病房运行效果. 解放军医院管理杂志, 2017, 24(2): 167-169.
19. 赵延慧, 唐楠, 韩琳, 等. 国内外日间手术患者延续性护理研究进展. 护理学报, 2018, 25(6): 24-27.

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