Meyer H-J
Department of General and Visceral Surgery, Städtisches Klinikum Solingen, 42653 Solingen, Germany.
Eur J Surg Oncol. 2005 Aug;31(6):595-604. doi: 10.1016/j.ejso.2005.03.002.
The background was to analyse the influence of hospital- and surgeon volume and of the extent of resective procedures on the quality of early and late treatment results in gastric cancer.
The literature was reviewed by searching the databases of Medline, Cancerlit, Pubmed and the Cochran register.
The levels of evidence showed wide variations. The influence of hospital volume was more important for the outcome than the case load of the individual surgeon. The extent of surgical resection should be adapted to histology--or stage. The value of systematic lymph node dissection is still under discussion.
We have found that the best treatment results were seen in high volume hospitals with experienced surgeons, even taking into account extended surgical procedures. Further studies are needed to define the optimal number of operations necessary to be carried out each year.
分析医院规模、外科医生手术量以及手术切除范围对胃癌早期和晚期治疗效果质量的影响。
通过检索医学索引数据库、癌症文献数据库、医学期刊数据库及考克兰图书馆来回顾相关文献。
证据水平差异很大。医院规模对治疗结果的影响比单个外科医生的手术量更为重要。手术切除范围应根据组织学或分期进行调整。系统性淋巴结清扫的价值仍在讨论中。
我们发现，即使考虑到扩大手术操作，在拥有经验丰富外科医生的大型医院中治疗效果最佳。需要进一步研究来确定每年所需进行的最佳手术数量。
