Schwab K E, Dowson H M, Van Dellen J, Marks C G, Rockall T A
Department of Colorectal Surgery, The Royal Surrey County Hospital, Guildford, Surrey, UK.
Colorectal Dis. 2009 Mar;11(3):318-22. doi: 10.1111/j.1463-1318.2008.01601.x.
The National Institute for Clinical Excellence (NICE) has recommended laparoscopic resection as an alternative to open surgery for patients with colorectal cancer. The aim of this study was to evaluate the current uptake of laparoscopic colorectal surgery in Great Britain and Ireland.
A questionnaire was distributed to members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) regarding their current surgical practice. Results were analysed individually, by region, and nationwide.
Information was received on 436 consultants (in 155 replies), of whom 233 (53%) perform laparoscopic colorectal procedures. During the previous year, 25% of colorectal resections were performed laparoscopically by the respondents. However, of those surgeons who were performing laparoscopic resections, only 30% performed more than half of all their resections laparoscopically. Right hemicolectomy, left-sided resections, and rectopexy were the most frequently performed laparoscopic resections. There was an even distribution throughout the country of consultants performing laparoscopic resections (regional IQR 48-60%). The main reason for consultants not performing laparoscopic procedures was a lack of training or funding.
Laparoscopic colorectal surgery is being performed by more than half (53%) of colorectal consultants nationwide, although only a quarter of all procedures are being undertaken laparoscopically.
英国国家卫生与临床优化研究所(NICE)已推荐将腹腔镜切除术作为结直肠癌患者开放手术的替代方案。本研究的目的是评估目前英国和爱尔兰腹腔镜结直肠癌手术的应用情况。
向英国和爱尔兰结直肠外科学会(ACPGBI)成员发放了一份关于他们当前手术实践的问卷。对结果进行了单独分析、按地区分析和全国范围分析。
收到了436名顾问医生的信息(共155份回复),其中233名(53%)进行腹腔镜结直肠手术。在过去一年中,受访者进行的结直肠切除术中25%是通过腹腔镜进行的。然而,在那些进行腹腔镜切除术的外科医生中,只有30%的医生超过一半的切除术是通过腹腔镜进行的。右半结肠切除术、左侧切除术和直肠固定术是最常进行的腹腔镜切除术。进行腹腔镜切除术的顾问医生在全国分布均匀(地区四分位距48 - 60%)。顾问医生不进行腹腔镜手术的主要原因是缺乏培训或资金。
全国超过一半(53%)的结直肠顾问医生进行腹腔镜结直肠癌手术,尽管所有手术中只有四分之一是通过腹腔镜进行的。