@article{oai:twinkle.repo.nii.ac.jp:00019777,
 author = {小林, 里絵 and 塩澤, 俊一 and 平野, 明 and 金, 達浩 and 土屋, 玲 and 石橋, 敬一郎 and 今野, 宗一 and 吉松, 和彦 and 渡辺, 修 and 勝部, 隆男 and 成高, 義彦 and 小川, 健治},
 issue = {2},
 journal = {東京女子医科大学雑誌},
 month = {Feb},
 note = {We investigated the clinical and financial effects of clinical pathways on 255 adults with 265 lesions of inguinal hernia as well as different types of surgical procedures over the past five years. The traditional tension repair (TR) method for hernia surgery has almost been replaced by the tension free repair (TF) techniques, which were applied to approximately 97% of the surgical cases in 2004. These two approaches showed no differences in the incidences of postoperative infections or the rates of disease recurrence, though there was a significant decrease in the occurrence of pains after surgery in patients who underwent procedures using the TF method (p = 0.012). In patients in whom clinical pathways were implemented, the duration of fluid or antibiotic treatment and the hospitalization period were greatly shortened as compared with those at baseline (p < 0.0001 and p = 0.0002, respectively) , indicating the clinical benefits of such pathways. Regarding the patients' medical care expenditures as indicated by the national health insurance claims, the claims per day markedly increased in patients subject to the use of the pathways compared with those without the pathways despite no significant difference in the total claims. The use of the TF method is expected to produce more favorable outcomes in the future if the clinical pathways are generally integrated into the management of hernia patients in the daily clinical practice.},
 pages = {77--81},
 title = {当科における成人鼠径ヘルニアに対する術式の変遷とクリニカルパスの導入効果について},
 volume = {76},
 year = {2006}
}