Bhandoria Geetu, Mane Jitendra D
1Department of Obstetrics & Gynecology, Command Hospital, Wanowrie, Pune, Maharashtra 411040 India.
2Obstetrician & Gynecologist, Department of Obstetrics & Gynecology, Command Hospital, Pune, Maharashtra India.
Indian J Surg Oncol. 2020 Mar;11(1):60-65. doi: 10.1007/s13193-019-00995-6. Epub 2019 Nov 7.
Surgeons constantly try to achieve optimal surgical outcome, number, or extent of postoperative complications being an important part of it. Oncological surgeries are conventionally more challenging and complex compared with most nononcological ones. Gawande et al. devised SAS in 2007 in Boston as a predictor tool for postoperative complications (J Am Coll Surg 204:201-208, 2007). A validation study was done by in another cohort of 100 patients; however, only 70% of them had pathologically confirmed malignancies (Ann Surg 240(2):205-213, 2004). We attempt to assess SAS as a tool to predict postoperative complications in a series of 100 gynecological oncological patients operated at tertiary care center. SAS score of 100 patients with gynecologic malignancies, undergoing surgery at a tertiary care center, was prospectively collected over 4 years. These patients were observed for development of any complications occurring up to 30 days postsurgery. The complication events were graded as per Clavien-Dindo classification (Indian J Gynecol Oncolog 15:49, 2017). The data obtained was statistically analyzed by chi-square test. Thirty complication events were recorded in these 100 patients over a period of 4 years. Majority of complication events were grade IIIa or less (22 out of 30); there was only one death on 8th postoperative day. Fifty percent of patients were with SAS score of 5 or less developed complications compared with just 22.9% in patients with a score of 6 or more. Lower SAS score might be associated with higher postoperative complications in patients undergoing gynecologic oncological surgeries. Thus, patients with lower scores may benefit from a triage to more intensive postoperative care.
外科医生一直致力于实现最佳手术效果，术后并发症的数量或程度是其中的重要组成部分。与大多数非肿瘤手术相比，肿瘤手术传统上更具挑战性和复杂性。2007年，高文德等人在波士顿设计了手术风险评估系统（SAS）作为术后并发症的预测工具（《美国外科医师学会杂志》204:201 - 208，2007年）。另一组100名患者进行了验证研究；然而，其中只有70%的患者经病理证实为恶性肿瘤（《外科学年鉴》240(2):205 - 213，2004年）。我们试图评估SAS作为预测在三级医疗中心接受手术的100例妇科肿瘤患者术后并发症的工具。在4年的时间里，前瞻性收集了在三级医疗中心接受手术的100例妇科恶性肿瘤患者的SAS评分。观察这些患者术后30天内发生的任何并发症。并发症事件按照Clavien - Dindo分类法进行分级（《印度妇科肿瘤学杂志》15:49，2017年）。对获得的数据进行卡方检验统计分析。在这4年期间，这100例患者记录了30例并发症事件。大多数并发症事件为IIIa级或更低（30例中的22例）；术后第8天仅有1例死亡。SAS评分为5分及以下的患者中有50%发生了并发症，而评分在6分及以上的患者中这一比例仅为22.9%。较低的SAS评分可能与妇科肿瘤手术患者较高的术后并发症相关。因此，评分较低的患者可能从分诊到更强化的术后护理中获益。
