根治性前列腺切除术：关于医院规模和外科医生手术量对患者预后影响的系统评价
Radical prostatectomy: a systematic review of the impact of hospital and surgeon volume on patient outcome.
作者信息
Wilson Ailsa, Marlow Nicholas E, Maddern Guy J, Barraclough Bruce, Collier Neil A, Dickinson Ian C, Fawcett Jonathon, Graham John C
机构信息
University of Adelaide Discipline of Surgery, The Queen Elizabeth Hospital, Adelaide, Australia.
出版信息
ANZ J Surg. 2010 Jan;80(1-2):24-9. doi: 10.1111/j.1445-2197.2009.05172.x.
BACKGROUND
To assess the impact of hospital and surgeon volume on mortality, morbidity, length of hospital stay and costs of radical prostatectomy (RP).
METHODS
This systematic review identified relevant studies published between 1997 and June 2007. Inclusion of papers was established through application of a predetermined protocol, independent assessment by two reviewers, and a final consensus decision.
RESULTS
Compared with low volume hospitals, the included studies showed high volume hospitals demonstrated lower rates of mortality, postoperative complications and readmissions, and lower overall hospital costs. High volume surgeons similarly showed lower rates of postoperative complications and shorter length of stay compared with low volume surgeons, but no difference in mortality.
CONCLUSIONS
From the literature obtained, patients undergoing RP performed by high volume providers may have better outcomes compared to low volume providers; however, any move to centralize RP must be further evaluated.
背景
评估医院和外科医生手术量对根治性前列腺切除术（RP）的死亡率、发病率、住院时间及费用的影响。
方法
本系统评价纳入了1997年至2007年6月发表的相关研究。通过应用预先制定的方案、两名评审员独立评估以及最终达成共识来确定论文的纳入。
结果
与手术量低的医院相比，纳入研究显示手术量高的医院死亡率、术后并发症及再入院率较低，总体住院费用也较低。与手术量低的外科医生相比，手术量高的外科医生术后并发症发生率同样较低，住院时间较短，但死亡率无差异。
结论
从所获文献来看，与手术量低的医疗服务提供者相比，接受手术量高的医疗服务提供者实施RP的患者可能有更好的预后；然而，任何将RP集中化的举措都必须进一步评估。
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