Present Status of Day-Case Nasal Surgery in Japan
Bibliographic record
Abstract
Recently in the USA, Canada, Australia, UK, and some European countries, a trend towards performing surgical procedures on an outpatient basis has been prompted by political, financial and medical forces. In such countries, the majority of elective surgery is performed on an ambulatory basis. In contrast, the Japanese medical service system seems to be reluctant to approve day-case surgery. Here, we describe the present status of nasal ambulatory surgery in Japan by presenting the data obtained from a questionnaire.Questionnaires were sent to 337 major hospitals in Japan that were qualified as training institutes by the Otolaryngologic Society of Japan. Answers were received from 248 hospitals. In 194 out of 248 hospitals (78%), some nasal surgery was performed on an outpatient basis. However, in most of the hospitals providing a positive response, only minimally invasive surgeries, such as cauterization of the inferior turbinates or polypotomies, were performed. Other, more invasive procedures were only performed on an outpatient basis in about one-fourth of the hospitals. The main reason why nasal surgery was not performed on an outpatient basis in the remaining 54 hospitals was the fear of complications.Although day-case septoplasty and turbinectomies were only performed in 6 and 30 institutes, respectively, nearly half of the chief otolaryngologists in the hospitals that responded to the questionnaire thought that these operations were safe to perform on an outpatient basis, which means surgeons are ready when opportunity is ripe.When asked about the factors that are essential for day surgery, the most frequent reply was “less bleeding”. Eighty two percent of the chief otolaryngologists in the hospitals that responded the survey believed that the number of outpatient surgical procedures would increase in the near future.According to the DECD Health Data 2001, Japan has fewer physicians and far more beds than most OECD member countries. Japan also has a longer average hospital stay and more outpatient consultation days. These factors produce a too busy clinical scene that does not favor the popularization of day surgery. Fear of medical mishaps is another factor inhibiting the widespread use of outpatient surgery.According to medical literature, the complication rate for septoplasty is around 10%, which is quite low. However, the unexpected admission rate after septoplasty is between 4 and 25%, which is greater than the acceptable figure acquired for day case surgery, which is less than 2%. Thus, at present, septoplasty should be performed as a short-stay procedure. If the present trend continues, however, more and more surgical procedures will be performed on an ambulatory basis in Japan.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".