Operative Hysteroscopy in an Office-Based Surgical Setting: Review of Patient Safety and Satisfaction in 414 Cases
Operative Hysteroscopy in an Office-Based Surgical Setting: Review of Patient Safety and Satisfaction in 414 Cases
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DOI：
10.1016/j.jmig.2012.08.778
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发表时间：
2013-01-01
影响因子：
4.1
通讯作者：
Ball, Courtney
中科院分区：
文献类型：
--
作者：
Wortman, Morris;Daggett, Amy;Ball, Courtney
研究目的：确定在门诊环境中接受宫腔镜手术的患者的安全性和满意度。设计：回顾性分析（加拿大工作组分类II-2）。设置：医生的私人办公室。患者：在办公室环境中接受手术宫腔镜检查的妇女。干预措施：387名妇女共接受了414例宫腔镜手术，使用胃肠外给予的中度镇静剂，9毫米手术切除镜和超声引导所有患者均为美国麻醉医师协会I-III级。测量和主要结果：共进行了305例初次手术宫腔镜手术，包括子宫内膜切除术、肌瘤切除术、息肉切除术、子宫中隔切除术和粘连松解术。109例（26.3%）既往子宫内膜消融术和切除术失败的女性进行了重复手术。平均手术需要平均（SD）37.6（13.5）分钟完成，并产生14.1（10.2）g组织。99%的手术已经完成。只有1名患者需要转院，以评价需要诊断性腹腔镜检查的子宫穿孔。有8例（1.9%）术后感染，没有并发症可归因于使用清醒镇静。255名妇女（65.6%）回答了我们的电话调查。252名（98.8%）受访者表示“非常满意”或“满意”。“249名女性（97.6%）更喜欢办公室而不是医院，而6名（2.4%）更喜欢医院。除5名受访者外，所有人都会向朋友推荐此程序。结论：大手术宫腔镜手术可以在办公室进行，具有高度的安全性和患者满意度。Journal of Minimally Invasive Gynecology（2013）20，56-63由Elsevier Inc.出版。关于AAGL
Study Objective: To determine the safety and satisfaction among patients undergoing operative hysteroscopy in an office-based setting.Design: Retrospective analysis (Canadian Task Force classification II-2).Setting: Physician's private office.Patients: Women undergoing operative hysteroscopy in an office setting.Interventions: Three hundred eighty-seven women underwent a total of 414 operative hysteroscopic procedures, with use of parenterally administered moderate sedation, a 9-mm operative resectoscope, and sonographic guidance. All patients were American Society of Anesthesiologists class I-III.Measurements and Main Results: A total of 305 primary operative hysteroscopic procedures were performed including endomyometrial resection, myomectomy, polypectomy, removal of a uterine septum, and adhesiolysis. One hundred nine (26.3%) repeat operative procedures were performed in women in whom previous endometrial ablation and resection had failed. The average procedure required a mean (SD) of 37.6 (13.5) minutes to complete, and produced 14.1 (10.2) g of tissue. Ninety-nine percent of all procedures were completed. Only 1 patient required a hospital transfer for evaluation of a uterine perforation necessitating diagnostic laparoscopy. There were 8 (1.9%) postoperative infections, and no complications attributable to use of conscious sedation. Two hundred fifty-five women (65.6%) responded to our telephone survey. Two hundred fifty-two (98.8%) respondents were either "very satisfied" or "satisfied." Two hundred forty-nine women (97.6%) preferred the office to a hospital setting, whereas 6 (2.4%) would have preferred a hospital setting. All but 5 respondents would recommend this procedure to a friend.Conclusion: Major operative hysteroscopic surgery can be performed in an office-based setting with a high degree of safety and patient satisfaction. Journal of Minimally Invasive Gynecology (2013) 20, 56-63 Published by Elsevier Inc. on behalf of AAGL.