Markar Sheraz R, Wahlin Karl, Mattsson Fredrik, Lagergren Pernilla, Lagergren Jesper
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden Department of Surgery & Cancer, Imperial College London, London, UK.
Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
BMJ Open. 2016 Sep 6;6(9):e013069. doi: 10.1136/bmjopen-2016-013069.
Previous studies indicate an increased short-term and long-term mortality from major cancer surgery performed towards the end of the working week or during the weekend. We hypothesised that the prognosis after major cancer surgery is also negatively influenced by surgery conducted during holiday periods.
Population-based nationwide Swedish cohort study.
Patients undergoing oesophagectomy for oesophageal cancer between 1987 and 2010. Among 1820 included patients, 206 (11.3%) and 373 (20.5%) patients were operated on during narrow and wide holiday periods, respectively.
Narrow (7 weeks) and wide (14 weeks) Swedish holiday periods.
90-day all-cause, 5-year all-cause and 5-year disease-specific mortality.
Narrow holiday period did not increase all-cause 90-day (HR=0.84, 95% CI 0.53 to 1.33), all-cause 5-year (HR=1.01, 95% CI 0.85 to 1.21) or disease-specific 5-year mortality (HR=1.04, 95% CI 0.87 to 1.26). Similarly, wide holiday period did not increase the risk of 90-day (HR=0.79, 95% CI 0.55 to 1.13), all-cause 5-year (HR=0.96, 95% CI 0.84 to 1.1) or disease-specific 5-year mortality (HR=1.03, 95% CI 0.89 to 1.19).
No measurable effects of holiday periods on short-term or longer term mortality following surgery for oesophageal cancer were observed in this population-based study, indicating that an adequate surgical experience was maintained during holiday periods.
既往研究表明，在工作周即将结束时或周末进行的重大癌症手术，其短期和长期死亡率会升高。我们推测，在节假日期间进行手术也会对重大癌症手术后的预后产生负面影响。
基于人群的瑞典全国队列研究。
1987年至2010年间因食管癌接受食管切除术的患者。在纳入的1820例患者中，分别有206例（11.3%）和373例（20.5%）患者在狭义和广义节假日期间接受手术。
瑞典狭义（7周）和广义（14周）节假日期间。
90天全因死亡率、5年全因死亡率和5年疾病特异性死亡率。
狭义节假日期间并未增加90天全因死亡率（风险比[HR]=0.84，95%置信区间[CI]为0.53至1.33）、5年全因死亡率（HR=1.01，95%CI为0.85至1.21）或5年疾病特异性死亡率（HR=1.04，95%CI为0.87至1.26）。同样，广义节假日期间也未增加90天全因死亡率（HR=0.79，95%CI为0.55至1.13）、5年全因死亡率（HR=0.96，95%CI为0.84至1.1）或5年疾病特异性死亡率（HR=1.03，95%CI为0.89至1.19）。
在这项基于人群的研究中，未观察到节假日期间对食管癌手术后短期或长期死亡率有可测量的影响，这表明在节假日期间仍保持了足够的手术经验。
