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巴西的肝切除术:一项全国性调查。

LIVER RESECTION IN BRAZIL: A NATIONAL SURVEY.

作者信息

Fonseca Gilton Marques, Jeismann Vagner Birk, Kruger Jaime Arthur Pirola, Coelho Fabricio Ferreira, Montagnini Andre Luis, Herman Paulo

机构信息

Department of Gastroenterology, Faculty of Medicine, University of São Paulo.

Brazilian Chapter of the International Hepato-Pancreato-Biliary Association, São Paulo, SP, Brazil.

出版信息

Arq Bras Cir Dig. 2018 Jun 21;31(1):e1355. doi: 10.1590/0102-672020180001e1355.

Abstract

BACKGROUND

Liver surgery has developed significantly in the past decades. In Brazil, the interest on it has grown significantly, but there is no study regarding its clinical practice. Despite intrinsic limitations, surveys are well suited to descriptive studies and allow understanding the current scenario.

AIM

To provide an overview on the current spread of liver surgery in Brazil, focusing on groups´ profile, operative techniques and availability of resources.

METHOD

From May to November 2016, was conducted a national survey about liver surgery profile in Brazil composed by 28 questions concerning surgical team characteristics, technical preferences, surgical volume, results and available institutional resources. The survey was sent by e-mail to 84 liver surgery team leaders from different centers including all regions of the country.

RESULTS

Forty-three study participants (51.2%), from all Brazilian regions, responded the survey. Most centers have residency/fellowship programs (86%), perform and do laparoscopic procedures (91%); however, laparoscopy is still responsible for a little amount of surgeries (1-9% of laparoscopic procedures over all liver resections in 39.5% of groups). Only seven centers (16.3%) perform more than 50 liver resections/year. Postoperative mortality rate is between 1-3% in 55% of the centers.

CONCLUSION

This is the first depiction of liver surgery in Brazil. It showed a surgical practice aligned with worldwide excellence centers, concentrated on hospitals dedicated to academic practice.

摘要

背景

在过去几十年中,肝脏手术有了显著发展。在巴西,人们对肝脏手术的兴趣大幅增长,但尚无关于其临床实践的研究。尽管存在固有局限性,但调查非常适合描述性研究,并有助于了解当前情况。

目的

概述巴西肝脏手术的当前普及情况,重点关注团队概况、手术技术和资源可用性。

方法

2016年5月至11月,对巴西肝脏手术概况进行了一项全国性调查,该调查由28个问题组成,涉及手术团队特征、技术偏好、手术量、结果和可用的机构资源。该调查通过电子邮件发送给来自包括巴西所有地区不同中心的84位肝脏手术团队负责人。

结果

来自巴西所有地区的43名研究参与者(51.2%)回复了调查。大多数中心有住院医师/研究员培训项目(86%),开展并进行腹腔镜手术(91%);然而,腹腔镜手术在所有肝脏切除术中所占比例仍然较小(在39.5%的团队中,腹腔镜手术占所有肝脏切除术的1 - 9%)。只有七个中心(16.3%)每年进行超过50例肝脏切除术。55%的中心术后死亡率在1 - 3%之间。

结论

这是对巴西肝脏手术的首次描述。它显示出一种与全球卓越中心相一致的手术实践,集中在致力于学术实践的医院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a380/6049998/9ca07a934ab0/0102-6720-abcd-31-01-e1355-gf1.jpg

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