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胃癌手术后围手术期安全检查表对术后并发症的影响:单中心初步研究。

Effects of a Perioperative Safety Checklist on Postoperative Complications Following Surgery for Gastric Cancer: A Single-Center Preliminary Study.

机构信息

Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an, China.

出版信息

Surg Innov. 2020 Apr;27(2):173-180. doi: 10.1177/1553350619894836. Epub 2020 Jan 2.

Abstract

. A Perioperative Safety Checklist (PSC) for gastric cancer (GC) was established to evaluate the effects of PSC on the clinical outcomes of GC. . This single-center preliminary observational study conducted at a tertiary referral hospital included patients with GC who underwent surgery from January 1, 2016, to June 30, 2016, treated without PSC (allocated to the control group) and those who underwent surgery between January 1, 2017, and June 30, 2017, managed according to the PSC designated as the PSCGC (Perioperative Safety Checklist for Gastric Cancer) group. . Overall, 1072 cases were enrolled, 556 cases in PSCGC group and 526 cases in control group. After matching, there were 474 patients in each group. PSC intervention led to significant reductions of the incidence of postoperative intestinal fistula formation ( = .034), the incidence of unplanned secondary surgery ( = 0.039), and the total hospitalization expenses ( < .001). Total completion rate of all 14 checklists items was 79.1%. Intraoperative blood loss in the complete and partial implementation groups was significantly lower than the complete nonimplementation group ( = .002), whereas hospitalization cost showed an opposite trend, which was significantly higher in the incomplete nonimplementation group ( = .015). . PSC implementation was associated with a decreased incidence of gastrointestinal fistula formation, unplanned secondary surgery, and hospitalization cost in patients with GC. However, it had no effect on the in-hospital mortality, the incidence of postoperative complications during hospitalization (ie, incision complications and lung infections), unplanned secondary admission, and the duration of postoperative hospital stay.

摘要

. 为评估围手术期安全检查表(PSC)对胃癌(GC)临床结局的影响,建立了一种用于胃癌的围手术期安全检查表。. 这项在一家三级转诊医院进行的单中心初步观察性研究,纳入了 2016 年 1 月 1 日至 2016 年 6 月 30 日期间接受手术但未行 PSC 治疗的 GC 患者(分配至对照组),以及 2017 年 1 月 1 日至 2017 年 6 月 30 日期间根据 PSC 进行治疗的 GC 患者(定义为 PSCGC 组)。. 共纳入 1072 例患者,PSCGC 组 556 例,对照组 526 例。匹配后,每组各有 474 例患者。PSC 干预显著降低了术后肠瘘形成的发生率(=.034)、计划性二次手术的发生率(= 0.039)和总住院费用(<.001)。14 项检查表项目的总完成率为 79.1%。完全和部分实施组的术中出血量明显低于完全未实施组(=.002),而住院费用则呈现相反的趋势,不完全未实施组的住院费用明显较高(=.015)。. PSC 的实施与 GC 患者胃肠道瘘形成、计划性二次手术和住院费用的减少有关。然而,它对住院期间死亡率、术后并发症(即切口并发症和肺部感染)、计划性二次入院以及术后住院时间无影响。

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