1st Department of Urology, University of Athens Medical School, Athens, Greece.
Department of Surgery, Urology Clinic, University of Verona, Verona, Italy.
Eur Urol. 2014 Sep;66(3):522-6. doi: 10.1016/j.eururo.2014.02.004. Epub 2014 Feb 14.
A standardised system to report outcomes and complications of urologic procedures has recently been proposed by an ad hoc European Association of Urology (EAU) Guidelines panel. To date, no studies have used these criteria to evaluate the quality of reports of outcomes and complications after partial nephrectomy (PN).
To address the quality of reporting of PN complications.
DESIGN, SETTING, AND PARTICIPANTS: A systematic review of papers reporting outcomes of PN was conducted through the electronic search of databases, including Medline, PubMed, Embase, Scopus, and the Cochrane Database of Systematic Reviews.
Analysis was carried out on structured forms. The quality criteria that the EAU Working Group proposed for reporting complications were recorded for each paper, and adherence to the Martin criteria was assessed.
Standardised criteria to report and grade complications were used in 71 out of 204 evaluable studies (34.8%). Only six studies (2.9%) fulfilled all criteria that the EAU Guidelines Office ad hoc panel proposed. The mean number did not change significantly by time or by surgical approach used. The most underreported criteria (in <50% of the studies) were who collected the data (18.6%), whether he or she were involved in the treatment (13.7%), duration of follow-up (47.1%), mortality data and causes of death (33.8%), definition of procedure-specific complications (39.2), separate reporting of intra- and postoperative complications (45.1%), complication severity or grade (32.4%), risk factors analysis (44.1%), readmission rates (12.7%), and percentage of patients lost to follow-up (6.9%). The mean number fulfilled was 6.5 ± 2.9 (mean plus or minus standard deviation) and did not change significantly by time or by surgical approach used.
The only way to improve the quality of the surgical scientific literature and to allow sound comparisons among different approaches, especially with the lack of randomised trials, is the use of more rigorous methodology than the one recently proposed to report outcomes and complications.
A rigorous methodology is mandatory when surgeons report about complications after surgery. Otherwise, the rate of adverse events is underestimated.
最近，一个欧洲泌尿外科协会（EAU）指南小组提出了一种标准化的报告泌尿科手术结果和并发症的系统。迄今为止，尚无研究使用这些标准来评估部分肾切除术（PN）后结果和并发症报告的质量。
解决 PN 并发症报告的质量问题。
设计、设置和参与者：通过电子搜索数据库，包括 Medline、PubMed、Embase、Scopus 和 Cochrane 系统评价数据库，对报告 PN 结果的论文进行了系统评价。
在结构化表格上进行分析。记录了 EAU 工作组提出的用于报告并发症的质量标准，并评估了对 Martin 标准的遵守情况。
在 204 项可评估研究中，有 71 项（34.8%）使用了标准化标准来报告和分级并发症。只有 6 项研究（2.9%）完全符合 EAU 指南办公室专门小组提出的所有标准。平均值并没有随着时间或手术方法的不同而显著变化。报告最少的标准（<50%的研究中）是收集数据的人（18.6%），他是否参与治疗（13.7%），随访时间（47.1%），死亡率数据和死亡原因（33.8%），手术特定并发症的定义（39.2%），分别报告围手术期并发症（45.1%），并发症严重程度或等级（32.4%），危险因素分析（44.1%），再入院率（12.7%）和失访患者比例（6.9%）。满足的平均值为 6.5 ± 2.9（平均值加或减标准差），并且没有随着时间或手术方法的不同而显著变化。
提高外科科学文献质量并允许对不同方法进行可靠比较的唯一方法是使用比最近提出的报告结果和并发症的方法更严格的方法。
外科医生报告手术后并发症时必须采用严格的方法。否则，不良事件的发生率会被低估。
