Nisen Harry, Järvinen Petrus, Fovaeus Magnus, Guðmundsson Eirikur, Kromann-Andersen Bjarne, Ljungberg Börje, Lund Lars, Nilsen Frode, Sundqvist Pernilla, Beisland Christian
a Department of Urology , Helsinki University Hospital , Helsinki , Finland.
b Department of Urology , Sahlgrenska University Hospital , Gothenburg , Sweden.
Scand J Urol. 2017 Oct;51(5):360-366. doi: 10.1080/21681805.2017.1326524. Epub 2017 Jun 23.
The five Nordic countries comprise 25 million people, and have similar treatment traditions and healthcare systems. To take advantage of these similarities, a collaborative group (Nordic Renal Cancer Group, NORENCA) was founded in 2015.
A questionnaire of 17 questions on renal tumor management and surgical education was designed and sent to 91 institutions performing renal tumor surgery in 2015. The response rate was 68% (62 hospitals), including 28 academic, 25 central and nine district hospitals. Hospital volume was defined as low (LVH: < 20 operations), intermediate (IVH: 20-49 operations), high (HVH: 50-99) and very high (VHVH: ≥ 100). Descriptive statistics were performed.
Fifteen centers were LVH, 16 IVH, 21 HVH and 10 VHVH. Of all 3828 kidney tumor treatments, 55% were radical nephrectomies (RNs), 37% partial nephrectomies (PNs) and 8% thermoablations. For RN and PN, the percentages of open, laparoscopic and robotic approaches were 47%, 40%, 13% and 47%, 20%, 33%, respectively. The mean complication rate (Clavien-Dindo 3-5) was 4.9%, and 30 day mortality (TDM) was 0.5%. The median length of hospital stay was 4 days. Training with a simulator, black box or animal laboratory was possible in 48%, 74% and 21% of institutions, respectively.
Despite some differences between countries, the data suggest an overall general common Nordic treatment attitude for renal tumors. Furthermore, the data demonstrate high adherence to international standards, with a high proportion of PN and acceptable rates for major complications and TDM.
北欧五国共有2500万人口，且有着相似的治疗传统和医疗体系。为利用这些相似之处，一个协作组（北欧肾癌组，NORENCA）于2015年成立。
设计了一份包含17个关于肾肿瘤管理和外科教育问题的问卷，并于2015年发送给91家进行肾肿瘤手术的机构。回复率为68%（62家医院），包括28家学术医院、25家中部医院和9家地区医院。医院手术量被定义为低（LVH：<20例手术）、中（IVH：20 - 49例手术）、高（HVH：50 - 99例手术）和非常高（VHVH：≥100例手术）。进行了描述性统计。
15个中心为LVH，16个为IVH，21个为HVH，10个为VHVH。在所有3828例肾肿瘤治疗中，55%为根治性肾切除术（RN），37%为部分肾切除术（PN），8%为热消融术。对于RN和PN，开放、腹腔镜和机器人手术方式的百分比分别为47%、40%、13%和47%、20%、33%。平均并发症发生率（Clavien - Dindo 3 - 5级）为4.9%，30天死亡率（TDM）为0.5%。住院时间中位数为4天。分别有48%、74%和21%的机构可以使用模拟器、黑箱或动物实验室进行培训。
尽管各国之间存在一些差异，但数据表明北欧对肾肿瘤总体上有共同的治疗态度。此外，数据显示高度遵循国际标准，PN比例高，主要并发症和TDM发生率可接受。
