Application research on the reduction of the rate of delayed connection of thoracoscopic lung nodule surgery in day surgery by refined management_West China Medical Journal

Authors：

ZHANG Yan , ZHU Hongmei ,  LIU Hang

Daytime Medical Center, Deyang People’s Hospital, Deyang, Sichuan 618000, P. R. China;

Corresponding?author：

LIU Hang, Email: liuhanghoney@163.com

Keywords：

Thoracoscopic lung nodule surgery; day surgery; refined management; rate of delayed

DOI：

10.7507/1002-0179.202511266

Video：

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Objective To investigate the effect of refined management on the reducing of the rate of delayed connection of thoracoscopic lung nodule surgery in day surgery. Methods Patients scheduled for thoracoscopic lung nodule surgery admitted to Daytime Medical Center of Deyang People’s Hospital from January to December 2022 and September 2023 to August 2024 were retrospectively selected. Patients admitted between January and December 2022 were divided into the pre-fine management group, while those admitted between September 2023 and August 2024 were divided into the post fine management group. The incidence of delayed connection of thoracoscopic lung nodule surgery in day surgery was compared between the two groups. Results A total of 888 patients were included. Among them, there were 419 cases in the pre-refined management group and 469 cases in the post refined management group. There was no statistically significant difference in the basic information between the two groups (P>0.05). In the pre-refined management group, 28 cases were delayed, the rate of delay was 6.68%. In the pre-refined management group, 7 cases were delayed, the rate of delay was 1.49%. There was a statistically significant difference in the occurrence of delayed reception between the two groups (χ²=15.744, P<0.001). Before refined management, the incidence of delayed reception caused by the patient’s own reasons and medical factors accounted for 28.57% (8/28) and 71.43% (20/28), respectively. Among them, the proportion of four factors was relatively high: preoperative examination imperfect and unqualified, anesthesia assessment not completed on time, surgical scheduling changed at will, and patients did not prepare for surgery according to the requirements. After refined management, the incidence of delayed reception caused by the patient’s own reasons and medical factors accounted for 71.43% (5/7) and 28.57% (2/7), respectively. Conclusion Refined management of daytime surgery is an effective measure to reduce the rate of delayed of thoracoscopic lung nodule surgery in daytime surgery.

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2.	王亮, 孟凡, 仇佳, 等. 經鼻濕化高流量吸氧在日間手術深度鎮靜中應用效果. 臨床軍醫雜志, 2025, 53(1): 46-49, 53.
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4.	侯夢薇, 蘭欣, 邢磊, 等. 大型綜合醫院日間手術信息管理平臺應用探討與實踐. 中國數字醫學, 2021, 16(2): 100-104.
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17.	張黎, 劉洋, 黃明君, 等. 胸腔鏡肺結節日間手術患者精細化管理效果研究. 華西醫學, 2021, 36(2): 183-189.
18.	馬曉旭, 林姣姣, 周海燕, 等. 構建信息化集中式術前麻醉評估體系的實踐. 中國衛生質量管理, 2021, 28(4): 65-67.
19.	梁鵬. 麻醉醫師在日間手術全流程管理中的作用. 實用醫學雜志, 2024, 40(8): 1031-1037.
20.	張嘉妮, 蔣秋鑫, 賴小琴, 等. 胸腔鏡肺結節日間手術圍手術期健康教育專家共識. 華西醫學, 2025, 40(2): 183-187.

1. 劉袁君, 肖繁, 劉爽, 等. 經臍“單孔+1”腹腔鏡膽囊切除術在日間手術中的應用體會. 腹腔鏡外科雜志, 2025, 30(6): 450-453.
2. 王亮, 孟凡, 仇佳, 等. 經鼻濕化高流量吸氧在日間手術深度鎮靜中應用效果. 臨床軍醫雜志, 2025, 53(1): 46-49, 53.
3. 雷甜甜, 梁鵬, 馬洪升, 等. 四川大學華西醫院日歸手術管理實踐. 廣東醫學, 2022, 43(10): 1222-1228.
4. 侯夢薇, 蘭欣, 邢磊, 等. 大型綜合醫院日間手術信息管理平臺應用探討與實踐. 中國數字醫學, 2021, 16(2): 100-104.
5. 王瑩, 劉琰, 孫輝. 我國日間手術資源配置公平性及效率研究. 中國醫院, 2022, 26(8): 2-5.
6. 江珊珊, 王悅, 馬海平. 肺部腫瘤患者日間與住院手術療效及費用比較的系統評價與 Meta 分析. 中國胸心血管外科臨床雜志, 2026, 33(1): 132-140.
7. 夏萍, 王衛, 夏志鵬, 等. 日間手術全程管理模式探索及實踐. 中國醫院, 2023, 27(8): 99-101.
8. Dumestre DO, Redwood J, Webb CE, et al. Enhanced recovery after surgery (ERAS) protocol enables safe same-day discharge after alloplastic breast reconstruction. Plast Surg (Oakv), 2021, 25(4): 249-254.
9. 朱宏, 王凱, 孫輝, 等. 日間手術規范化管理實證調查分析. 中國醫院, 2022, 26(8): 6-9.
10. MingJun H, Yan D, JiPing L, et al. Thirty-day unplanned readmission after ambulatory laparoscopic cholecystectomy in western China: a retrospective study. Cureus, 2021, 13(3): e13932.
11. 高正, 干海琴. 眼科日間手術信息化管理體系的構建. 中華醫院管理雜志, 2022, 37(1): 47-50.
12. Jiang L, Zhou K, Che G, et al. Response to: estimated direct costs of non-small cell lung cancer by stage at diagnosis and disease management phase: a whole-disease model. Thorac Cancer, 2021, 12(5): 732-733.
13. 楊思捷, 楊珂璐, 田小合, 等. 基于國際日間手術協會年會摘要熱點主題的聚類分析和循證可視化研究. 中國實用外科雜志, 2022, 42(12): 1408-1415, 1427.
14. 李海鵬, 葛鋒. 日間手術存在的問題與優化策略探討. 中國醫院管理, 2022, 42(6): 64-66.
15. Li H, Zhang W, Lu Q, et al. Which frequency of ankle pump exercise should be chosen for the prophylaxis of deep vein thrombosis?. Inquiry, 2022, 59: 469580221105989.
16. 莫洋, 袁磊, 劉蔚東, 等. 基于德爾菲法和層次分析法的日間手術質量與安全評價指標體系構建. 華西醫學, 2024, 39(2): 184-189.
17. 張黎, 劉洋, 黃明君, 等. 胸腔鏡肺結節日間手術患者精細化管理效果研究. 華西醫學, 2021, 36(2): 183-189.
18. 馬曉旭, 林姣姣, 周海燕, 等. 構建信息化集中式術前麻醉評估體系的實踐. 中國衛生質量管理, 2021, 28(4): 65-67.
19. 梁鵬. 麻醉醫師在日間手術全流程管理中的作用. 實用醫學雜志, 2024, 40(8): 1031-1037.
20. 張嘉妮, 蔣秋鑫, 賴小琴, 等. 胸腔鏡肺結節日間手術圍手術期健康教育專家共識. 華西醫學, 2025, 40(2): 183-187.

West China Medical Journal

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