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一项多中心前瞻性审计,旨在调查英国接受抗反流手术患者的当前管理情况:抗反流手术及检查的审计与回顾

A multicenter prospective audit to investigate the current management of patients undergoing anti-reflux surgery in the UK: Audit & Review of Anti-Reflux Operations & Workup.

作者信息

Walker Rob, Wiggins Tom, Blencowe Natalie S, Findlay John M, Wilson Michael, Currie Andrew C, Hornby Steve, Markar Sheraz R, Rahman Saqib, Lloyd Megan, Hollyman Marianne, Jaunoo Shameen

机构信息

Cancer Sciences, University of Southampton, Southampton, UK.

出版信息

Dis Esophagus. 2021 Jul 12;34(7). doi: 10.1093/dote/doaa129.

Abstract

BACKGROUND

There are a variety of surgical and endoscopic interventions available to treat gastroesophageal reflux disease. There is, however, no consensus on which approach is best.The aim of this national audit is to describe the current variation in the UK clinical practice in relation to anti-reflux surgery (ARS) and to report adherence to available clinical guidelines.

METHODS

This national audit will be conducted at centers across the UK using the secure online web platform ALEA. The study will comprise two parts: a registration questionnaire and a prospective multicenter audit of ARS. All participating centers will be required to complete the registration questionnaire comprising details regarding pre-, peri-, and post-operative care pathways and whether or not these are standardized within each center. Following this, a 12-month multicenter prospective audit will be undertaken to capture data including patient demographics, predominant symptoms, preoperative investigations, surgery indication, intraoperative details, and postoperative outcomes within the first 90 days.Local teams will retain access to their own data to facilitate local quality improvement. The full dataset will be reported at national and international scientific congresses and will contribute to peer-reviewed publications and national quality improvement initiatives.

CONCLUSIONS

This study will identify and explore variation in the processes and outcomes following ARS within the UK using a collaborative cohort methodology. The results generated by this audit will facilitate local and national quality improvement initiatives and generate new possibilities for future research in anti-reflux interventions.

摘要

背景

有多种外科手术和内镜干预方法可用于治疗胃食管反流病。然而,对于哪种方法最佳尚无共识。这项全国性审计的目的是描述英国抗反流手术(ARS)临床实践中的当前差异,并报告对现有临床指南的遵循情况。

方法

这项全国性审计将通过安全的在线网络平台ALEA在英国各地的中心进行。该研究将包括两个部分:一份注册问卷和一项关于ARS的前瞻性多中心审计。所有参与中心都将被要求完成注册问卷,其中包括术前、术中和术后护理路径的详细信息,以及这些信息在每个中心是否标准化。在此之后,将进行为期12个月的多中心前瞻性审计,以收集包括患者人口统计学、主要症状、术前检查、手术指征、术中细节以及术后90天内的术后结果等数据。当地团队将保留对其自身数据的访问权限,以促进当地的质量改进。完整的数据集将在国内和国际科学大会上报告,并将为同行评审的出版物和国家质量改进计划做出贡献。

结论

本研究将使用协作队列方法识别和探索英国ARS术后过程和结果的差异。本次审计产生的结果将促进地方和国家的质量改进计划,并为未来抗反流干预研究创造新的可能性。

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