中小腹壁疝日间手术规范化流程中国专家共识(2022版)
Chinese expert consensus on standard process of ambulatory surgery for small and medium ventral hernia (2022 edition)
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摘要: 中小腹壁疝指腹壁缺损最大径≤8 cm的腹壁疝,其手术操作相对简单、术后恢复较快,具备开展日间手术治疗的可行性。应根据实际情况建设腹壁疝日间手术设施,设计过程中应充分考虑各方人员需求。应组建多学科、多部门的日间手术团队,设立相关准入制度,以实现对日间手术运营流程和状态的有效管理。应明确患者选择标准,根据患者具体情况个体化选择手术方式和修补材料,重视围手术期管理及相关风险评估,建立突发状况应急预案,确保患者的医疗安全。应通过使用临床路径、合理分析质量控制指标等途径,实现对医疗质量的有效评价。此外在实施过程中,应根据医院具体情况稳妥推进。Abstract: Small and medium ventral hernia refers to abdominal wall hernia with maximum diameter of abdominal wall defect less than 8 cm, of which operation procedures and postoperative recovery are predictable, making it feasible to launch ambulatory surgery. Day surgery facilities for ventral hernia operations should be constructed on the basis of the actual circumstance, with full consideration of all the needs of different personnel. A multi‑disciplinary and multi-departmental day surgery team with an access system is expected to be established, so as to achieve proper management of the surgery. Clarified inclusion criteria for patients, individual selection of operation programs and meshes, highly attention paid to perioperative management and risk assessment, and contingency plans for emergencies, are supposed to lead to ensured medical safety. Through the application of the clinical pathway and reasonable analysis of quality control indicators, effective evaluation of medical quality is expectable. In addition, the implementation process should be carried out steadily in accordance with the specific situation of the hospital.