通过基于远程医疗的腹股沟疝治疗术前会诊评估患者的术后效果

IF 2.6 2区 医学 Q1 SURGERY Hernia Pub Date : 2024-09-18 DOI:10.1007/s10029-024-03095-9
Zev Felix, Gustavo Salgado-Garza, Caroline G. Porter, Nelly Nouboussi, Amber L. O’Connor, Alina Bazarian, Vahagn C. Nikolian
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引用次数: 0

摘要

目的 在远程医疗在医疗保健系统中日益受到重视的时代,将其纳入术前评估规程既是挑战也是机遇。术前评估在为每位患者确定最佳行动计划方面发挥着重要作用。最近有研究报告称,经过远程医疗术前会诊后,手术效果良好。本研究在腹股沟疝修补术术前会诊的背景下,考察了远程医疗相对于传统面对面评估的功效,并深入探讨了如何将远程医疗用于术前评估。方法我们分析了一家三级转诊医院的前瞻性单中心数据库,该医院设有专门的疝和腹壁重建中心,我们对接受远程医疗(电话或视频)术前会诊的患者与仅接受面对面门诊的患者进行了术前、术中和术后变量比较。结果 265 名接受腹股沟疝修补术的患者被纳入其中,其中 60 人仅接受了远程医疗,其余均为亲自就诊。分析发现,远程医疗组和面对面组的术后并发症发生率没有差异。远程医疗组术前与外科医生会面的次数较少(P < 0.001)。结论根据我们的分析,在腹股沟疝修补术中使用远程医疗进行术前评估对选择这种方法的患者来说是一种可行且安全的选择,有可能重塑外科实践中的术前模式。
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Postoperative outcomes among patients evaluated via telemedicine-based preoperative consultations for inguinal hernia care

Purpose

In an era where telehealth is gaining traction within healthcare systems, its integration into preoperative assessment protocols presents both challenges and opportunities. Preoperative assessments have an important role in determining the best plan of action for each patient. Recent studies have reported adequate operative outcomes after telemedicine preoperative consultations. This study examines telehealth’s efficacy relative to traditional in-person evaluations in the context of preoperative consultations for inguinal hernia repairs and provides a deeper insight into how telemedicine might be utilized for pre-surgical assessments.

Methods

We analyzed a prospectively maintained single-center database at a tertiary referral hospital with a dedicated hernia and abdominal wall reconstruction center for pre, intra and postoperative variables comparing patients that received telemedicine (phone or video) preoperative consultations versus in-person clinic visits only. Secondary analysis with propensity score matching was employed to adjust for possible confounders.

Results

265 patients that underwent inguinal hernia repair were included, with 60 encounters being telemedicine only and the rest in-person. This analysis found no difference in rates of postoperative complications between the telemedicine and in-person groups. The telemedicine group required less preoperative encounters with their surgeon (P < 0.001). In the preoperative in-person group, 41% switched to virtual follow-ups, while in the virtual group, only 18% chose in-person follow-ups (P = 0.003).

Conclusions

Based on our analysis, the use of telemedicine for preoperative assessments in inguinal hernia repairs as a feasible and safe choice for patients opting for this approach, potentially reshaping the preoperative paradigm in surgical practices.

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来源期刊
Hernia
Hernia SURGERY-
CiteScore
4.90
自引率
26.10%
发文量
171
审稿时长
4-8 weeks
期刊介绍: Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
期刊最新文献
Complications related to the prehabilitation with preoperative pneumoperitoneum in loss of domain hernias: our experience in 180 consecutive cases. Navigating uncharted territory: robotic repair of a rare primary perineal hernia. Comment to: The effect of surgical repair of hiatal hernia (HH) on pulmonary function. Comment to: The modified frailty index predicts postoperative morbidity in elective hernia repair patients. The impact of opioid versus non-opioid analgesics on postoperative pain level, quality of life, and outcomes in ventral hernia repair.
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