外科专科住院医师能够安全地实施直肠癌切除术。

Surgical specialist registrars can safely perform resections for carcinoma of the rectum.

作者信息

Tytherleigh Matthew, Wheeler James, Birks Meg, Farouk Ridzuan

机构信息

Department of Surgery, Royal Berkshire and Battle Hospitals, Reading, UK.

出版信息

Ann R Coll Surg Engl. 2002 Nov;84(6):389-92. doi: 10.1308/003588402760978175.

DOI:10.1308/003588402760978175

PMID:12484577

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2504205/

Abstract

AIM

To assess morbidity, mortality and cancer-related outcomes after supervised rectal resection for cancer by surgical specialist registrars (SpRs).

PATIENTS

A total of 205 consecutive patients (115 male; median age 64 years [range, 24-90 years]) under the care of six consultant surgeons, who underwent elective rectal resection of their rectal cancer between 1995-1999 were studied. The modified Dukes' stages were A in 28 patients (13%), B in 47 (21%), C in 103 (51%), and D in 30 (15%).

RESULTS

Sixty-eight patients (35 males) of mean age 64 years (range, 38-82 years) underwent supervised resection (60 anterior resections. 8 abdomino-perineal resections) by a SpR. Of these, 7 (10%) were modified Dukes' stage A, 16 (22%) stage B, 37 (54%) stage C, and 8 (13%) stage D. Postoperative morbidity (SpRs 32% versus consultants 41%; P = 0.25) and mortality (SpRs 3% versus consultants 6%; P = 0.1) were comparable with consultant outcomes. Local recurrence rates (SpRs 9% versus consultants 9%; P = 0.5) and crude survival (SpRs 64% versus consultants 61%; P = 0.31) were also comparable after a median follow-up of 48 months (range, 24-72 months).

CONCLUSION

Operative and cancer-related outcomes are not compromised by supervised SpR resections of rectal cancer in selected patients.

摘要

目的

评估外科专科住院医师（SpRs）在有监督情况下进行直肠癌切除术后的发病率、死亡率及癌症相关结局。

患者

对在6位顾问外科医生照料下，于1995年至1999年间接受择期直肠癌切除术的205例连续患者（115例男性；中位年龄64岁[范围24 - 90岁]）进行研究。改良Dukes分期：A期28例（13%），B期47例（21%），C期103例（51%），D期30例（15%）。

结果

68例平均年龄64岁（范围38 - 82岁）的患者（35例男性）接受了SpR的有监督切除术（60例低位前切除术，8例腹会阴联合切除术）。其中，改良Dukes分期A期7例（10%），B期16例（22%），C期37例（54%），D期8例（13%）。术后发病率（SpRs为32%，顾问医生为41%；P = 0.25）和死亡率（SpRs为3%，顾问医生为6%；P = 0.1）与顾问医生的结局相当。中位随访48个月（范围24 - 72个月）后，局部复发率（SpRs为9%，顾问医生为9%；P = 0.5）和总生存率（SpRs为64%，顾问医生为61%；P = 0.31）也相当。