Bassi Claudio, Andrianello Stefano
General and Pancreatic Surgery - The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
General and Pancreatic Surgery - The Pancreas Institute, University of Verona Hospital Trust, Verona, Italy.
HPB (Oxford). 2017 Mar;19(3):178-181. doi: 10.1016/j.hpb.2016.12.002. Epub 2017 Jan 16.
Indicators of effectiveness and quality of care are of greatest importance in gauging the direct benefit of a new surgical technique, such as minimally-invasive pancreatic resections, when being compared with established approaches.
Current expert opinion on minimally-invasive pancreatic resection (MIPR) was presented at the first MIPR state of the art conference during 12th world congress of the International Hepato-Pancreato-Biliary Association.
Studies exploring outcome of the minimally-invasive approach, alone or compared with open surgery, should consider all the necessary indicators of quality ensuring a high level of clinical care. Such studies should be implemented in a context that guarantees the correct indication for surgery, lower mortality rates, a low burden of post-operative morbidity through early recognition of adverse events and prevention of predictable complications, high standards of oncological "radicality", prompt recovery with access to adjuvant therapy as soon as possible, and reduction of health-care related costs.
Only by integrating MIPR with the outcome-improving effect of a dedicated pancreatic team will it be possible to assess more precisely the putative benefits of this minimally-invasive approach.
在将诸如微创胰腺切除术等新的外科技术与既定方法进行比较时,疗效指标和医疗质量指标对于衡量其直接益处至关重要。
在国际肝胆胰协会第12届世界大会期间召开的首届微创胰腺切除术(MIPR)前沿技术会议上,展示了当前关于微创胰腺切除术的专家意见。
探索微创方法单独或与开放手术相比的结果的研究,应考虑所有必要的质量指标,以确保高水平的临床护理。此类研究应在保证手术适应症正确、降低死亡率、通过早期识别不良事件和预防可预测的并发症降低术后发病率负担、高标准的肿瘤“根治性”、尽快恢复并能尽快接受辅助治疗以及降低医疗相关成本的背景下进行。
只有将微创胰腺切除术与专业胰腺团队的改善结果效果相结合,才有可能更精确地评估这种微创方法的假定益处。