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丹麦腹疝数据库的建立和初步经验。

Establishment and initial experiences from the Danish Ventral Hernia Database.

机构信息

Department of Surgical Gastroenterology, Herlev Hospital, The Danish Hernia Database, Copenhagen, Denmark.

出版信息

Hernia. 2010 Apr;14(2):131-5. doi: 10.1007/s10029-009-0592-0. Epub 2009 Nov 24.

Abstract

PURPOSE

Outcome after ventral hernia repair is not optimal. The surgical technique relies on personal preferences or evidence from small-scale studies, rather than large-scale prospective data with high external validity. The purpose of this paper was to describe the establishment and potential of the Danish Ventral Hernia Database (DVHD). Furthermore, the first 2-year data from 2007 to 2008 are presented.

METHODS

Registrations were based on surgeons' web registrations and validated by cross checking with data from the Danish National Patient Register.

RESULTS

The DVHD was established in June 2006 and is based on prospective online web-registration of perioperative data, and individualised tracking of follow up data. During the first 2 years (2007-2008) data showed a large variation in almost all aspects of ventral hernia repair regarding surgical technique, use of open versus laparoscopic technique, use of mesh or no mesh, type of suture material, and placement of the mesh. A total of 5,629 elective and 661 acute ventral hernia repairs were registered. After the first 2 years the registration rate was 70%.

CONCLUSION

The first national ventral hernia database has been established. Preliminary results call for large-scale prospective and randomised studies to improve outcomes. Overall, the DVHD may facilitate identification of surgical technical problems and contribute to improved outcomes. The initial registration rate of 70% is inadequate and initiatives have been undertaken to reach >95% of all hernia repairs as in the Danish Inguinal Hernia Database.

摘要

目的

腹疝修补术后的效果并不理想。手术技术依赖于个人偏好或小规模研究的证据,而不是具有高度外部有效性的大规模前瞻性数据。本文旨在描述丹麦腹疝数据库(DVHD)的建立和潜力。此外,还呈现了 2007 年至 2008 年的头两年数据。

方法

注册基于外科医生的网络注册,并通过与丹麦国家患者登记处的数据交叉核对进行验证。

结果

DVHD 于 2006 年 6 月建立,基于围手术期数据的前瞻性在线网络注册,以及对随访数据的个体化跟踪。在头两年(2007-2008 年),数据显示在腹疝修复的几乎所有方面都存在很大差异,包括手术技术、开放与腹腔镜技术的使用、是否使用网片、缝合材料的类型以及网片的放置。共登记了 5629 例择期和 661 例急性腹疝修复。在头两年后,登记率为 70%。

结论

已经建立了第一个全国性的腹疝数据库。初步结果呼吁开展大规模的前瞻性和随机研究,以改善结果。总体而言,DVHD 可能有助于确定手术技术问题,并有助于改善结果。最初的登记率为 70%,不足以采取措施达到丹麦腹股沟疝数据库中所有疝修复的 95%以上。

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