Exploration and practice of day surgery and enhanced recovery after surgery for thoracic sympathectomy

doi:10.3877/cma.j.issn.1674-6899.2022.04.009

Abstract

Abstract:

Objective

To explore the safety and feasibility of day surgery and enhanced recovery surgery in thoracic sympathectomy.

Methods

The data of 657 patients with primary hyperhidrosis who underwent thoracic sympathectomy from Jan. 2016 to Dec.2020 in the Thoracic Department of The Third People′s Hospital of Shenzhen were retrospectively analyzed. Among them, 273 were male and 384 were female. 14-43 (24±5) years, divided into day group and overnight group. The hospitalization time, operation time, complications, satisfaction, postoperative compensatory sweating, surgical appointment cancellation rate, unplanned reoperation, unplanned rehospitalization and other indicators were analyzed between the two groups.

Results

There was no statistical significance in the operation time, anesthesia time, number of effective cases, the number of cases of compensatory sweating, the number of unplanned reoperations, and the number of unplanned rehospitalizations between the two groups (P>0.05). Compared with the overnight group, the patients in the day group had a shorter hospital stay [(9.6±1.1)h vs (24.8±6.6)h, P<0.05], and fewer postoperative nausea and vomiting (7 cases vs 23 cases, P<0.05). Surgical appointment cancellation rate was high (15 cases vs 0 case, P< 0.05), and patient satisfaction was high [90 (90, 95) vs 85 (80, 90)].

Conclusions

The concept of day surgery and enhanced recovery surgery can be safely used in thoracoscopic thoracic sympathectomy.

Key words: Day surgery, Enhanced recovery after surgery, Primary hyperhidrosis, Thoracic sympathectomy, Video-assisted thoracic surgery

Qinlang Shi, Pilai Huang, Shuo Zheng, Qiang Fu, Yanfeng Wang, Danying Yin, Sisi Wang, Ning Xiang, Kun Qiao. Exploration and practice of day surgery and enhanced recovery after surgery for thoracic sympathectomy[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2022, 15(04): 233-237.

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URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2022.04.009

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2022/V15/I04/233

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References 18

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项目		日间组(431例)	过夜组(226例)	统计值	P值
年龄(岁，±s)		25.0±5.6	24.8±6.6	t＝0.43	0.66
性别[男/女，例(%)]		172(39.9)/ 259(60.1)	101(44.7)/ 125(55.3)	χ²＝1.39	0.23
代偿性出汗程度[例(%)]				χ²＝0.89	0.36
	中度	23(5.3)	16(7.1)
	重度	408(94.7)	210(92.9)

项目		日间组(431例)	过夜组(226例)	统计值	P值
年龄(岁，±s)		25.0±5.6	24.8±6.6	t＝0.43	0.66
性别[男/女，例(%)]		172(39.9)/ 259(60.1)	101(44.7)/ 125(55.3)	χ²＝1.39	0.23
代偿性出汗程度[例(%)]				χ²＝0.89	0.36
	中度	23(5.3)	16(7.1)
	重度	408(94.7)	210(92.9)

项目	日间组(431例)	过夜组(226例)	统计值	P值
住院时间(h，±s)	9.6±1.1	48.7±4.6	t＝4.35	<0.01
手术时间(min，±s)	29.1±7.3	30.1±7.3	t＝1.52	0.12
麻醉时间(min，±s)	59.6±7.8	59.3±9.0	t＝0.47	<0.63
术中出血量>100 ml[例(%)]	0(0.0)	0(0.0)		－
气胸(肺压缩≥30%)[例(%)]	0(0.0)	0(0.0)		－
延迟性出血[例(%)]	0(0.0)	0(0.0)		－
延迟性气胸[例(%)]	1(0.2)	0(0.0)	χ²＝0.52	0.47
术后恶心和呕吐[例(%)]	7(1.6)	23(10.2)	χ²＝24.80	<0.01
非计划再次手术[例(%)]	0(0.0)	0(0.0)		－
非计划再次住院[例(%)]	1(0.2)	0(0.0)	χ²＝0.52	0.47
预约取消[例(%)]	15(3.5)	0(0.0)	χ²＝8.04	<0.01
满意度[分，中位数(四分间距)]	90(90，95)	85(80，90)		－
手术有效[例(%)]	431(100.0)	226(100.0)		－
代偿性出汗[例(%)]	305(70.8)	169(74.8)	χ²＝1.18	0.27

项目	日间组(431例)	过夜组(226例)	统计值	P值
住院时间(h，±s)	9.6±1.1	48.7±4.6	t＝4.35	<0.01
手术时间(min，±s)	29.1±7.3	30.1±7.3	t＝1.52	0.12
麻醉时间(min，±s)	59.6±7.8	59.3±9.0	t＝0.47	<0.63
术中出血量>100 ml[例(%)]	0(0.0)	0(0.0)		－
气胸(肺压缩≥30%)[例(%)]	0(0.0)	0(0.0)		－
延迟性出血[例(%)]	0(0.0)	0(0.0)		－
延迟性气胸[例(%)]	1(0.2)	0(0.0)	χ²＝0.52	0.47
术后恶心和呕吐[例(%)]	7(1.6)	23(10.2)	χ²＝24.80	<0.01
非计划再次手术[例(%)]	0(0.0)	0(0.0)		－
非计划再次住院[例(%)]	1(0.2)	0(0.0)	χ²＝0.52	0.47
预约取消[例(%)]	15(3.5)	0(0.0)	χ²＝8.04	<0.01
满意度[分，中位数(四分间距)]	90(90，95)	85(80，90)		－
手术有效[例(%)]	431(100.0)	226(100.0)		－
代偿性出汗[例(%)]	305(70.8)	169(74.8)	χ²＝1.18	0.27

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