After nearly 30 years of localized development of day surgery in China, in order to enable more patients to enjoy high-quality and affordable day surgery medical services, some medical institutions have begun to try same-day surgery, which means the patient can be operated and discharged within the same workday. With the help of the national three-level diagnosis and treatment service model, it provides continuous medical services and guarantees for day surgery patients through the integration of “hospital-community”. This article first introduces the development history of day surgery, summarizes the definitions and requirements of day surgery in different countries or academic associations, and finally focuses on same-day surgery in China, aims to provide some ideas for the future development of day surgery in China.
Under the same-day surgery mode, anesthesiologists play an important role in ensuring patient safety, eliminating medical risks, practicing the concept of enhanced recovery after surgery, and realizing comfortable diagnosis and treatment, and a standardized anesthesia management process is the key to protect patients. Based on the principled suggestions in The Consensus of Chinese Experts on Anaesthesia for Day Surgery, combined with the advanced management experience of day surgery anesthesia at home and abroad, and repeatedly revised through practice, a comprehensive, rigorous, and standardized anesthesia management process for same-day surgery was gradually explored by the First Affiliated Hospital of Dalian Medical University. This paper introduces the process from the aspects of procedure of anesthesia evaluation in same-day surgery, preoperative preparation, standardized intraoperative anesthesia management, postoperative pain management, and prevention and treatment of postoperative complications.
Objective To investigate the safety and effect of same-day discharge in injection sclerotherapy for children with hemangioma (IJCH) and tension-free hernioplasty for adults with inguinal herinia (TFHA). Methods A retrospective analysis was conducted on patients undergoing IJCH or TFHA in the Day Surgery Center of West China Hospital of Sichuan University between November 2020 and October 2021. According to the patient’s condition and willingness, they were divided into same-day discharge group (162 children and 180 adults) and overnight hospitalization group (68 children and 271 adults). The amount of intraoperative bleeding, length of hospital stay, hospitalization expenses, pain before discharge, and short-term postoperative complications were compared between the two groups. Visual analogue scale was used for pain assessment in adults and children over 6 years old, and smiley face score was used in children below 6 years old. Results Compared with those in the overnight discharge group, the amount of intraoperative bleeding in the same-day discharge group was less [IJCH: (0.45±0.05) vs. (2.76±1.21) mL, P<0.05; TFHA: (1.20±0.05) vs. (6.76±2.30) mL, P<0.05], length of hospital stay was shorter [IJCH: (7.99±1.22) vs. (23.10±1.42) h, P<0.05; TFHA: (6.13±1.79) vs. (22.75±1.80) h, P<0.05], hospitalization cost was lower [IJCH: (5094.00±1320.14) vs. (6263.52±1220.20) yuan, P<0.05; TFHA: (7199.21±1535.84) vs. (7976.82±1967.82) yuan, P<0.05], pain before discharge was milder (IJCH: 0.05±0.02 vs. 0.50±0.01, P<0.05; TFHA: 1.20±0.01 vs. 2.01±0.20, P<0.05). There was no significant difference in the incidence of postoperative complications or unplanned revisit within 30 days between the two modes (P>0.05). Conclusions The same-day surgery mode is safe and feasible in IJCH and TFHA, and can shorten the length of hospital stay and reduce the cost of hospitalization. It is suggested to popularize this mode in clinical practice.
The Day Surgery Center of West China Tianfu Hospital of Sichuan University began operation in 2022, with a focus on same-day surgery. To ensure the quality of medical care for patients undergoing same-day surgery, the Day Surgery Center of West China Tianfu Hospital of Sichuan University utilizes information technology support and adopts an innovative patient health education model. This article mainly introduces the whole process management of health education for patients undergoing same-day surgery mentioned above, which involves many links before admission, during hospitalization, and after discharge. The aim is to provide reference for further optimization of same-day surgery and improve the quality and effectiveness of health education for patients undergoing same-day surgery.