Solomon Matthew, Cochrane Colin T, Grieve David A
School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Department of Surgery, Nambour General Hospital, Nambour, Queensland, Australia.
ANZ J Surg. 2016 Jan-Feb;86(1-2):84-7. doi: 10.1111/ans.13107. Epub 2015 Apr 19.
The aim of this study was to compare the time to re-operation, following inadequate loco-regional surgery for breast cancer, between the public and private sectors of the Sunshine Coast region.
A retrospective review was performed of the medical records of all female patients undergoing guide wire-localized, breast-conserving surgery at Nambour General Hospital and in the local private sector from January 2009 until April 2010. The dates of initial consultation, operation, post-operative consultation and any subsequent reoperation were recorded.
One hundred and seventeen public sector patients and 113 private sector patients were identified during the study period. Thirty-seven public patients (32%) and 46 private patients (41%) required re-operation. This difference was not significant (χ(2) = 2.06, degrees of freedom (df) = 1, P = 0.15). The mean time and standard error from the initial consultation to the first operation and re-operation in the public sector was 26 (2.3) and 62 (3.8) days, and in the private sector was 12 (1.2) and 30 (4.4) days, respectively P < 0.001. On average, 70% of public patients and 96% of private patients completed the surgical component of their breast cancer management within the Queensland Health-recommended time frame of 30 days (χ(2) = 26, df = 1, P < 0.001).
While experiencing similar rates of re-operative surgery in breast cancer management in the public and private sectors, the private sector deals with this issue in a more time efficient manner. An opportunity for intervention by quarantining theatre time is explored to improve the public sector time management.
本研究旨在比较阳光海岸地区公立和私立部门对乳腺癌进行局部手术不充分后再次手术的时间。
对2009年1月至2010年4月在楠伯综合医院和当地私立部门接受导丝定位保乳手术的所有女性患者的病历进行回顾性研究。记录初次会诊、手术、术后会诊及任何后续再次手术的日期。
研究期间共确定了117名公立部门患者和113名私立部门患者。37名公立患者（32%）和46名私立患者（41%）需要再次手术。这种差异不显著（χ² = 2.06，自由度（df）= 1，P = 0.15）。公立部门从初次会诊到首次手术和再次手术的平均时间及标准误差分别为26（2.3）天和62（3.8）天，私立部门分别为12（1.2）天和30（4.4）天，P < 0.001。平均而言，70%的公立患者和96%的私立患者在昆士兰卫生部门建议的30天时间框架内完成了乳腺癌治疗的手术部分（χ² = 26，df = 1，P < 0.001）。
虽然公立和私立部门在乳腺癌治疗中再次手术的发生率相似，但私立部门处理这个问题的时间效率更高。探讨了通过预留手术时间进行干预以改善公立部门时间管理的机会。
