Nihon Geka Gakkai zasshi
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Pediatric patients with inguinal hernia can be good candidates for day surgery. Since 1986, 1273 such patients have been treated under our day surgery system. Although 8 patients (0.6%) were unable to go home after surgery due to perioperative complications and 21 (1.6%) visited earlier than scheduled after discharge, no major complications were noted and postoperative complications did not differ from those seen in the inpatient setting. ⋯ Based on our own experience and a literature review of day surgery for inguinal hernia repair in children, the problems surrounding the day care system are discussed. Patient selection, preoperative assessment, general anesthesia, postoperative care including oral intake and analgesia, and postoperative follow-up are considered the most important issues in the day care system. A team approach including pediatric surgeons, anesthesiologists, and pediatric nurses is considered indispensable for the safe and satisfactory day surgery treatment.
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Ambulatory surgery comprised up to 70% of scheduled surgery in the USA during the past decades. The main reason for the increase was economic. In Japan, day surgery has been performed in the pediatric field, such as for inguinal hernia. ⋯ Postoperative care occurs at home. To reduce postoperative complications, skilled surgery, prompt recovery from anesthesia, and postoperative care using sophisticated systems, manpower, and equipment are necessary. To ensure patient safety, the Japan Society for Ambulatory Anesthesia announced a set of "safety standards for ambulatory anesthesia" in 1999 and we continue to work to developing protocols that maximize the safety of and benefits to patients.