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Tempo de internamento no tratamento das hérnias da região inguinal no CHLN : estudo comparativo entre dois períodos com um intervalo de 10 anos
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Introdução: As hérnias da região inguinal são a patologia mais comumente submetida a intervenção cirúrgica, verificando-se, nas últimas décadas, evolução nas técnicas e abordagens cirúrgicas. O objetivo deste trabalho é comparar a casuística entre dois períodos que distam 10 anos entre si, tendo como principal outcome as diferenças entre o tempo de internamento em cada um deles.
Métodos: Estudo retrospetivo onde foram incluídos 1336 indivíduos adultos diagnosticados com hérnias da região inguinal, internados no CHLN-EPE entre Janeiro/2004-Junho/2005 (Subgrupo 1) e Janeiro/2014-Junho/2015 (Subgrupo 2).
Resultados: Entre os doentes incluídos, o número de intervenções laparoscópicas aumentou cerca de 4 vezes em 2014/15 face aos dados de 2004/05. A percentagem de intervenções em ambulatório registada foi de 6.3% e de 38.4% em cada subgrupo. O tempo de internamento médio registado foi de 3.3 e 1.8 dias em cada subgrupo, verificando-se maior tempo de internamento nos doentes submetidos a intervenções laparoscópicas. Doentes com idade ≥80 anos, sujeitos a cirurgias concomitantes ou com complicações pós-operatórias têm maior tempo de internamento.
Conclusões: A principal conclusão é que a duração média do tempo de internamento em 2014/15 foi reduzida em cerca de 45% desde 2004/05 (de 3.3 para 1.8 dias), com as principais diferenças a centrarem-se no aumento do número de cirurgias em ambulatório e a redução do tempo de internamento pré-operatório.
Introduction: Inguinal and femoral hernias are the most common disease that is submitted to surgical treatment. In the last few decades, new surgical techniques and different treatment approaches emerge. The aim of this work is to put together the data of patients diagnosed with inguinal/femoral hernia between two periods of time with a gap of 10 years. The main outcome is to compare the differences between hospital stay in each period. Methods: Data analised retrospectively who were included 1336 adult patients diagnosed with inguinal and femoral hernias who were inpatient on CHLN-EPE hospital between January/2004-June/2005 (Subgrupo 1) and January/2014-June/2015 (Subgrupo 2). Results: On the patients included in this study, the laparoscopic approach increased about 4 times in 2014/15 comparing to the data collected in 2004/05. The percent of patients who underwent outpatient surgery was 6.3% and 38.4% in each group. The mean duration of hospital stay was 3.3 and 1.8 days in each subgroup, with longer hospitalization time in patients who underwent laparoscopic approach. Patients with age ≥80 years old, who were submitted to other procedures in the same chirurgical time or have post-procedures complications appears to have longer hospital stay. Conclusions: The main outcome taken out with this study is that the average number of days inpatient decreases about 45% if we compare the years 2004/05 with 2014/15 (from 3.3 to 1.8 days). The major differences were the increase of the percent of the surgery made in ambulatory and the reduction of hospital stay days before surgery takes place.
Introduction: Inguinal and femoral hernias are the most common disease that is submitted to surgical treatment. In the last few decades, new surgical techniques and different treatment approaches emerge. The aim of this work is to put together the data of patients diagnosed with inguinal/femoral hernia between two periods of time with a gap of 10 years. The main outcome is to compare the differences between hospital stay in each period. Methods: Data analised retrospectively who were included 1336 adult patients diagnosed with inguinal and femoral hernias who were inpatient on CHLN-EPE hospital between January/2004-June/2005 (Subgrupo 1) and January/2014-June/2015 (Subgrupo 2). Results: On the patients included in this study, the laparoscopic approach increased about 4 times in 2014/15 comparing to the data collected in 2004/05. The percent of patients who underwent outpatient surgery was 6.3% and 38.4% in each group. The mean duration of hospital stay was 3.3 and 1.8 days in each subgroup, with longer hospitalization time in patients who underwent laparoscopic approach. Patients with age ≥80 years old, who were submitted to other procedures in the same chirurgical time or have post-procedures complications appears to have longer hospital stay. Conclusions: The main outcome taken out with this study is that the average number of days inpatient decreases about 45% if we compare the years 2004/05 with 2014/15 (from 3.3 to 1.8 days). The major differences were the increase of the percent of the surgery made in ambulatory and the reduction of hospital stay days before surgery takes place.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Hérnia inguinal Hérnia femoral Tipos de reparação cirúrgica de hérnia inguinal Tempo de internamento