Urology Institute University of Southern California (USC), Los Angeles, CA, United States; Department of Urology, University of Verona, Verona, Italy.
Urology Institute University of Southern California (USC), Los Angeles, CA, United States.
Eur Urol Focus. 2020 May 15;6(3):513-517. doi: 10.1016/j.euf.2018.12.004. Epub 2018 Dec 23.
The definition of a surgical complication still lacks standardization, hampering evaluation of surgical performance in this regard. Over the years, efforts to address this issue have been carried out to improve reporting of outcomes. In 2012, the European Association of Urology (EAU) proposed a standardized reporting tool for urological complications. The aim of this study was to evaluate the impact of those recommendations on complication reporting for patients undergoing robotic partial nephrectomy (RPN). A comprehensive systematic review of all English language publications on RPN was carried out. We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses statement and Agency for Healthcare Research and Quality guidelines in evaluating articles retrieved from the PubMed, Scopus, and Web of Science databases (January 1, 2000 to October 31, 2016; updated June 2017). The quality of reporting and grading complications was assessed according to the EAU recommendations. Temporal comparison revealed an improvement in outcome reporting in terms of mortality rates and causes of death (p=0.05), definition of complications (p<0.001), procedure-specific complications (p=0.02), severity grade (p<0.001), postoperative complications presented by grade/complication type (p<0.001), and risk factors (p<0.001). Our analysis demonstrates an improvement in complication reporting and grading after the EAU recommendation on RPN. PATIENT SUMMARY: Complications are unexpected events that could negatively impact a patient's outcomes after surgery, but there is no agreement on the definition and reporting of complications. In 2012, the European Association of Urology proposed a standardized reporting tool for urological complications. This study shows an improvement in the way physicians report complications after robotic partial nephrectomy. The results underline the importance of standardization in medicine to improve clinical research.
手术并发症的定义仍然缺乏标准化，这妨碍了对此类手术表现的评估。多年来，人们一直致力于解决这个问题，以改善结果报告。2012 年，欧洲泌尿外科学会（EAU）提出了一种用于泌尿科并发症的标准化报告工具。本研究旨在评估这些建议对机器人辅助部分肾切除术（RPN）患者并发症报告的影响。我们对所有英语语言的 RPN 出版物进行了全面的系统综述。我们遵循系统评价和荟萃分析的首选报告项目和医疗保健研究与质量机构的指南，评估从 PubMed、Scopus 和 Web of Science 数据库检索到的文章（2000 年 1 月 1 日至 2016 年 10 月 31 日；2017 年 6 月更新）。根据 EAU 建议评估报告和分级并发症的质量。时间比较显示，在死亡率和死亡原因（p=0.05）、并发症定义（p<0.001）、特定于手术的并发症（p=0.02）、严重程度分级（p<0.001）、术后并发症按分级/并发症类型呈现（p<0.001）以及危险因素（p<0.001）方面，结果报告得到了改善。我们的分析表明，在 EAU 关于 RPN 的建议之后，并发症报告和分级得到了改善。
并发症是手术后可能对患者结果产生负面影响的意外事件，但对并发症的定义和报告没有达成一致意见。2012 年，欧洲泌尿外科学会提出了一种用于泌尿科并发症的标准化报告工具。本研究显示，在报告机器人辅助部分肾切除术后并发症方面，医生的报告方式有所改善。结果强调了医学标准化在改善临床研究方面的重要性。
