Chang Andrew C, Birkmeyer John D
Section of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor 48109, USA.
Thorac Surg Clin. 2006 Feb;16(1):87-94. doi: 10.1016/j.thorsurg.2006.01.008.
The current literature demonstrates that both hospital volume and surgeon volume are inversely related to operative mortality for esophageal resection. Given the heterogeneity of the volume-outcome literature, it is difficult to identify minimum volume thresholds at which satisfactory performance is achieved. Both volume-based hospital referral and process improvement provide compelling and sometimes competing strategies for translating evidence about volume-outcome relationships into policy. Each approach has significant limitations that preclude uniform implementation nationwide but nonetheless should be a focus for continued investigation and application, with the goal of providing uniform and high-quality care after esophagectomy.
当前文献表明，医院手术量和外科医生手术量均与食管切除术的手术死亡率呈负相关。鉴于手术量与预后关系文献的异质性，很难确定能实现满意手术效果的最低手术量阈值。基于手术量的医院转诊和流程改进，为将手术量与预后关系的证据转化为政策提供了引人关注且有时相互竞争的策略。每种方法都有显著局限性，妨碍在全国范围内统一实施，但尽管如此，仍应作为持续研究和应用的重点，目标是在食管切除术后提供统一且高质量的护理。
