Abstract：
BACKGROUND:Single visit surgery (SVS) consists of same-day pre-operative assessment and operation with telephone post-operative follow-up. This reduces family time commitment to 1 hospital trip rather than 2-3. We began SVS for ambulatory patients with clear surgical indications in 2013. We sought to determine family satisfaction, cost savings to families, and institutional financial feasibility of SVS. METHODS:SVS patients were compared to age/case matched conventional surgery (CS) patients. Satisfaction was assessed by post-operative telephone survey. Family costs were calculated as the sum of lost revenue (based on median income) and transportation costs ($0.50/mile). RESULTS:Satisfaction was high in both groups (98% for SVS vs. 93% for CS; p=0.27). 40% of CS families indicated that they would have preferred SVS, whereas no SVS families indicated preference for the CS option (p<0.001). Distance from the hospital did not correlate with satisfaction. Estimated cost savings for an SVS family was $188. Reimbursement, hospital and physician charges, and day-of-surgery cancellation rates were similar. CONCLUSIONS:SVS provides substantial cost savings to families while maintaining patient satisfaction and equivalent institutional reimbursement. SVS is an effective approach to low-risk ambulatory surgical procedures that is less disruptive to families, facilitates access to pediatric surgical care, and reduces resource utilization. TYPE OF STUDY:Cost Effectiveness Study. LEVEL OF EVIDENCE:Level II.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Olson JK,Deming LA,King DR,Rager TM,Gartner S,Huibregtse N,Moss RL,Besner GEdoi
10.1016/j.jpedsurg.2017.10.021subject
Has Abstractpub_date
2017-10-10 00:00:00eissn
0022-3468issn
1531-5037pii
S0022-3468(17)30643-7pub_type
杂志文章abstract：:A statewide survey of pediatric surgery was sponsored by the Connecticut Society of American Board Surgeons to determine the general surgeons attitudes about performing routine and complex pediatric surgery, the absolute volume of index pediatric surgical conditions in the state, and the proportion treated by pediatri...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(75)90377-2
更新日期：1975-10-01 00:00:00
abstract：BACKGROUND/PURPOSE:The management of neonates with giant omphalocele remains challenging and multiple strategies have been described. We present the case of a 34-week-old neonate with isolated giant omphalocele managed with an external surgical skin closure system as a component of a staged closure strategy. CASE PRES...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2010.05.004
更新日期：2010-07-01 00:00:00
abstract：:Esophageal resection or replacement has become the standard therapy for severe esophageal strictures chiefly because less aggressive methods generally have failed. We hereby report our experience with 12 consecutive infants and children who have been managed successfully by means of Stamm gastrostomy and string-guided...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80529-9
更新日期：1989-08-01 00:00:00
abstract：:Three infants with progressive upper esophageal stenosis had bilateral vocal fold paralysis. The patients were apparently normal at birth and without neurologic abnormality. Cricopharyngeal myotomy, followed by serial dilatations, relieved esophageal stenosis and restored the swallowing function. Vocal fold mobility, ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2004.07.022
更新日期：2004-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:Vascular anomalies are a diverse set of lesions with distinct clinical behaviors, whose biomolecular characteristics are largely undefined. Common hemangiomas proliferate during the first year of life, then involute at a variable pace over several years. Other vascular tumors may involute much more q...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2003.11.043
更新日期：2004-03-01 00:00:00
abstract：:An adrenal mass in a newborn usually suggests a diagnosis of neuroblastoma or hemorrhage. A 6-week-old girl was referred for evaluation of a left adrenal mass. The initial findings were most consistent with an adrenal hemorrhage. On surveillance imaging, the lesion was characterized as a complex cystic mass. The patie...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.03.083
更新日期：2012-07-01 00:00:00
abstract：:The leading cause of death in the neonatal period is respiratory failure, and extracorporeal membrane oxygenation (ECMO) is an effective means of improving survival in select patients. Only neonates with severe hypoxia and acidosis are treated with ECMO. To determine the developmental outcome of the neonates we suppor...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(05)80162-9
更新日期：1990-01-01 00:00:00
abstract：PURPOSE:Percutaneous endoscopic gastrostomy (PEG) has been widely accepted as an efficacious means of nutritional support in the infant and child. A well-described technique uses the Gauderer-Ponsky tube (CR Bard Incorporated, Tewksbury, MA) drawn antegrade through the gastric wall and secured by an internal and extern...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90445-6
更新日期：1998-02-01 00:00:00
abstract：BACKGROUND:In addition to trauma center levels and types, trauma volume may be an important factor impacting outcomes in severe pediatric trauma. METHODS:All severely injured pediatric patients treated at adult trauma centers were identified from the National Trauma Data Bank. All qualifying centers were stratified in...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2017.01.066
更新日期：2017-11-01 00:00:00
abstract：:While most situations of peritonitis, perforation and compromised blood flow in necrotizing enterocolitis are best handled by resection and stoma formation, primary resection and anastomosis should be considered in selected cases. Nine premature infants with NEC underwent bowel resection with primary anastomosis in th...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(79)80500-x
更新日期：1979-06-01 00:00:00
abstract：:Fetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate fetus is incorporated within its twin. The authors report the case of a newborn boy with prenatal ultrasonographic diagnosis of intraabdominal mass, provoking compression of the left kidney. Plain abdominal radiography, ultrasonography, and compu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jpedsurg.2003.12.029
更新日期：2004-04-01 00:00:00
abstract：:Cystic lesions of the spleen are uncommon, about 600 cases being reported in the world literature. This report concerns three pediatric patients treated by partial splenectomy for benign cyst. In the world literature most of the cystic lesions of the spleen are treated by splenectomy and more recently by partial splen...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(86)80357-8
更新日期：1986-09-01 00:00:00
abstract：OBJECTIVE:To study the differential expression of genes between Hirschsprung's disease (HSCR) and normal tissue by using microarray for exploring the mechanism of HSCR development and establishing the gene expression profiles of HSCR. METHODS:Colon tissues (aganglionic and normal segments) of 4 patients with HSCR were...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.06.024
更新日期：2013-11-01 00:00:00
abstract：BACKGROUND/PURPOSE:The authors have investigated hepatocyte transplantation using biodegradable polymer scaffolds as a possible treatment of end-stage liver disease. The purpose of this study was to investigate the survival rate and function of hepatocytes alone or cocultured with other cell types on 3-dimensional biod...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2000.9298
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:The treatment of incidentally encountered asymptomatic Meckel diverticulum (MD) is controversial. We evaluated whether the macroscopic appearance correlates with clinical features, histopathological findings, future complications, and management decisions. METHODS:Patients who underwent MD resection at a si...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2015.08.066
更新日期：2016-07-01 00:00:00
abstract：PURPOSE:This study reviews adrenocortical tumors in children to determine factors that significantly affect outcome. METHODS:An institutional review board-approved retrospective review from 1976 to 2005 identified 23 patients younger than 19 years old with histologic confirmation of adrenocortical carcinoma (ACC) and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.12.022
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:Orthotopic liver transplantation (OLT) is the only treatment option for unresectable hepatoblastoma (HB) and hepatocellular carcinoma (HCC) in children. Aggregated outcomes of OLT for these hepatic malignancies have not been evaluated in the United Network for Organ Sharing national database. PURPOSE:The pu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.10.091
更新日期：2006-01-01 00:00:00
abstract：:Three newborn boys presented with features suggestive of classic low anorectal abnormality. However, during surgery they were found to have an intermediate anorectal abnormality and a rectoperineal fistula rather than an anocutaneous fistula. The surgical treatment of these infants is discussed. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90085-x
更新日期：1994-04-01 00:00:00
abstract：PURPOSE:A fecalith is a fecal concretion that can obstruct the appendix leading to acute appendicitis. We hypothesized that the presence of a fecalith would lead to an earlier appendiceal perforation. METHODS:Between January 2001 and December 2005, the charts of all patients younger than 18 years old who underwent app...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.12.034
更新日期：2008-05-01 00:00:00
abstract：PURPOSE:Tracheal obstruction by granulation tissue can compromise the postoperative course in congenital tracheal stenosis (CTS). Balloon dilatation and stenting may be required. Budesonide is a corticosteroid with topical anti-inflammatory effects. In 2008, we used inhaled budesonide for treatment of postoperative gra...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.11.041
更新日期：2014-02-01 00:00:00
abstract：PURPOSE:The congenital central alveolar hypoventilation syndrome (CCAHS), also known as Ondine curse, is characterized by the absence of adequate autonomic control of respiration. The purpose of our study is to review our 20-year experience with diaphragmatic pacing as a treatment modality for CCAHS. METHODS:After obt...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2007.12.013
更新日期：2008-05-01 00:00:00
abstract：:In adults, small bowel diaphragm disease is a rare complication of small bowel enteropathy secondary to the use of nonsteroidal antiinflammatory drugs. The main clinical manifestations are gastrointestinal bleeding and subacute obstruction, and management can be challenging. We present a case of a 5-year-old girl with...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.05.003
更新日期：2012-08-01 00:00:00
abstract：:Marine envenomations are the statistical price that humankind pays for intruding into the aquatic domain. Individual risk can be reduced by knowledge and prudence. If envenomations do occur, lives can be saved, complications prevented, and convalescence facilitated by knowledge of and interest in these fascinating cre...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章,评审
doi：10.1016/0022-3468(95)90622-3
更新日期：1995-01-01 00:00:00
abstract：:In a 4-year span, 12 patients with hepatic trauma were treated at our institution. After initial resuscitation, three underwent emergency celiotomy because of the severity of their injuries. This communication analyses the other nine. All of these had significant liver injuries and were managed nonoperatively. Hepatic...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(84)80093-7
更新日期：1984-10-01 00:00:00
abstract：:This report suggests that stabilization of the intrauterine to extrauterine transitional circulation combined with a respiratory care strategy that avoids pulmonary overdistension, takes advantage of inherent biological cardiorespiratory mechanics, and very delayed surgery for congenital diaphragmatic hernia results i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(95)90042-x
更新日期：1995-03-01 00:00:00
abstract：:The management of 108 patients with posterior urethral valves from 7 pediatric surgical centers has been reviewed. All the patients have been treated in the 10 year period since 1970. 53 were under 3 mo of age at presentation (Group I), 8 between 3 mo and 1 yr (Group II), 22 between 1 and 5 yr (Group III), and 25 over...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80276-0
更新日期：1983-02-01 00:00:00
abstract：:Sirenomelia, or the mermaid syndrome, is the most extreme example of the caudal regression syndrome. It invariably presents with lower limb fusion, sacral and pelvic bony anomalies, absent external genitalia, anal imperforation, and renal agenesis or dysgenesis. Because of the resultant oligohydramnios, these infants ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(91)90614-y
更新日期：1991-11-01 00:00:00
abstract：:The management of giant omphalocele remains a major surgical challenge. A staged approach is mandatory to achieve an uncomplicated reduction. The case of a child conservatively and successfully treated by progressive external compression of the herniated organs and viscera using an elastic bandaging is described here....
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90061-5
更新日期：1996-12-01 00:00:00
abstract：PURPOSE:Expandable metallic stents (Palmaz stents) have been used in the treatment of tracheobronchial obstruction in children and adults. The authors investigated their utility in the management of acute airway stenosis in a growing animal model. METHODS:A model for tracheal stenosis was developed in young lambs (mea...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(98)90527-9
更新日期：1998-07-01 00:00:00
abstract：BACKGROUND/PURPOSE:Delivery of local anesthesia for surgical office procedures for pediatric patients can be difficult. Injections are painful and often lead to patient anxiety, and topical anesthetics frequently provide incomplete anesthesia. The authors prospectively studied the efficacy of iontophoresis, a needle-fr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(99)90765-0
更新日期：1999-06-01 00:00:00
