中心手术量对减瘤手术及热灌注化疗术后结局的影响。
Impact of surgical volume of centers on post-operative outcomes from cytoreductive surgery and hyperthermic intra-peritoneal chemoperfusion.
作者信息
Rajeev Rahul, Klooster Brittany, Turaga Kiran K
机构信息
Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
出版信息
J Gastrointest Oncol. 2016 Feb;7(1):122-8. doi: 10.3978/j.issn.2078-6891.2015.099.
Abstract
Complex surgical operations performed at centers of high volume have improved outcomes due to improved surgical proficiency, and betters systems of care including avoidance of errors. Cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemoperfusion (HIPEC), which has been shown to be an oncologically effective strategy for peritoneal carcinomatosis (PC), is one such procedure with significant morbidity and mortality. The learning curve to reach technical proficiency in CRS + HIPEC is about 140-220 cases for a center. Focus on improving surgical proficiency through training, improving systems of care through partnerships and reporting mechanisms for quality could reduce the time to proficiency.
摘要
在高手术量中心进行的复杂外科手术，由于手术熟练度的提高以及包括避免错误在内的更好的护理系统，使得手术结果得到了改善。细胞减灭术（CRS）和热灌注化疗（HIPEC）已被证明是治疗腹膜癌（PC）的一种肿瘤学有效策略，但这是一种具有较高发病率和死亡率的手术。一个中心达到CRS + HIPEC技术熟练的学习曲线约为140 - 220例。通过培训专注于提高手术熟练度，通过合作关系改善护理系统以及建立质量报告机制，可以缩短达到熟练程度的时间。
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