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Japanese

Evaluation of our clinical pathway for laparoscopy-assisted colorectal surgery Atsushi NISHIMURA 1 , Keiya NIKKUNI 1 , Yasuyuki KAWACHI 1 , Shigeto MAKINO 1 , Tetsuya NAITOU 1 , Taku ISHIKAWA 1 , Motoko TAKAHASHI 1 , Tomohiro MARUYAMA 1 1Department of Surgery in Digestive Disease Center, Nagaoka Chuo General Hospital Keyword: 腹腔鏡下大腸癌手術 , クリニカルパス pp.745-749
Published Date 2010/12/15
DOI https://doi.org/10.11477/mf.4426100558
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 This study is aimed to assess the validity and the usefulness of our original clinical pathway(CP)for laparoscopy-assisted colectomy(LAC). We set up the discharge day on the 5 th post operative day(POD)since 2005(new CP, n=117). Discharge day was set on the 9 th POD prior to 2005(old CP, n=31)and this was used as a comparison control. Ninety nine LAC patients(99/117=84.6%)attained the discharge standard of 5 th POD, and 32 patients(27.4%)were actually discharged by 5 th POD. The incidence of variance was high in patients of 80 years or older and for those with rectal cancer. Short-term results were compared between patients who underwent new CP and those for old CP. There was no difference in the incidence of complications between the two groups(16/117=13.7%vs 6/31=19.4%, P=0.429). The average postoperative hospital stay for patients in new CP(7.7 days)was significantly shorter than those in old CP(11.5 days)(P<0001). The hospitalization health care cost per day was significantly higher in new CP(9178 points)than in old CP(6373 points)(P<0.001). In conclusion, new CP is appropriate and useful. In the future, individualization of the CP would be necessary to achieve patients'satisfaction.


Copyright © 2010, JAPAN SOCIETY FOR ENDOSCOPIC SURGERY All rights reserved.

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電子版ISSN 2186-6643 印刷版ISSN 1344-6703 日本内視鏡外科学会

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