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奥地利腹腔镜结肠手术的现状:一项全国性调查。

Current State of Laparoscopic Colonic Surgery in Austria: A National Survey.

作者信息

Klugsberger Bettina, Haas Dietmar, Oppelt Peter, Neuner Ludwig, Shamiyeh Andreas

机构信息

1 Second Surgical Department, Kepler University Hospital , Linz, Austria .

2 Linz Training and Research Center for Surgery and Oncology, Kepler University Hospital , Linz, Austria .

出版信息

J Laparoendosc Adv Surg Tech A. 2015 Dec;25(12):976-81. doi: 10.1089/lap.2015.0373. Epub 2015 Nov 24.

Abstract

PURPOSE

Several studies have demonstrated that laparoscopic colonic resection has significant benefits in comparison with open approaches in patients with benign and malignant disease. The proportion of colonic and rectal resections conducted laparoscopically in Austria is not currently known; the aim of this study was to evaluate the current status of laparoscopic colonic surgery in Austria.

MATERIALS AND METHODS

A questionnaire was distributed to all general surgical departments in Austria. In collaboration with IMAS, an Austrian market research institute, an online survey was used to identify laparoscopic and open colorectal resections performed in 2013. The results were compared with data from the National Hospital Morbidity Database (NHMD), in which administrative in-patient data were also collected from all general surgical departments in Austria in 2013.

RESULTS

Fifty-three of 99 surgical departments in Austria responded (53.5%); 4335 colonic and rectal resections were carried out in the participating departments, representing 50.5% of all NHMD-recorded colorectal resections (n = 8576) in Austria in 2013. Of these 4335 colonic and rectal resections, 2597 (59.9%) were carried out using an open approach, 1674 (38.6%) were laparoscopic, and an exact classification was not available for 64 (1.5%). Among the NHMD-recorded colonic and rectal resections, 6342 (73.9%) were carried out with an open approach, and 2234 (26.1%) were laparoscopic.

CONCLUSIONS

The proportion of colorectal resections that are carried out laparoscopically is low (26.1%). Technical challenges and a learning curve with a significant number of cases may be reasons for the slow adoption of laparoscopic colonic surgery.

摘要

目的

多项研究表明,与开放性手术相比,腹腔镜结肠切除术对于患有良性和恶性疾病的患者具有显著优势。目前尚不清楚奥地利腹腔镜结肠和直肠切除术的实施比例;本研究的目的是评估奥地利腹腔镜结肠手术的现状。

材料与方法

向奥地利所有普通外科科室发放了一份问卷。与奥地利市场研究机构IMAS合作,通过在线调查确定2013年实施的腹腔镜和开放性结直肠切除术。将结果与国家医院发病率数据库(NHMD)的数据进行比较,该数据库中也收集了2013年奥地利所有普通外科科室的住院患者管理数据。

结果

奥地利99个外科科室中有53个做出了回应(53.5%);参与调查的科室共进行了4335例结肠和直肠切除术,占2013年奥地利NHMD记录的所有结直肠切除术(n = 8576)的50.5%。在这4335例结肠和直肠切除术中,2597例(59.9%)采用开放性手术,1674例(38.6%)为腹腔镜手术,64例(1.5%)无法进行确切分类。在NHMD记录的结肠和直肠切除术中,6342例(73.9%)采用开放性手术,2234例(26.1%)为腹腔镜手术。

结论

腹腔镜结直肠切除术的实施比例较低(26.1%)。技术挑战以及大量病例的学习曲线可能是腹腔镜结肠手术采用缓慢的原因。

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