Department of General Surgery, Singapore General Hospital, 20 College Road, Academia, Singapore, 169856, Singapore.
World J Emerg Surg. 2021 Aug 28;16(1):43. doi: 10.1186/s13017-021-00390-z.
Hybrid operating theatres (OT) allow for simultaneous interventional radiology and operative procedures, serving as a one-stop facility for the treatment of severely injured patients. Several countries have adopted the use of the hybrid OT however their clinical impact in improving efficiency and quality of care remains unclear. This study systematically reviews the clinical impact of the hybrid OT for treatment of the severely injured.
A literature review of the PubMed, Embase and Cochrane databases was performed to identify all published articles in English, from 1st January 2000 to 31st December 2020, reporting on the impact of a hybrid OT for severe trauma. Articles were also reviewed for references of interest.
Five studies reporting the clinical impact of the hybrid OT, in a total of 951 patients, were shortlisted. All were cohort studies that compared patient outcomes in the hybrid OT versus a conventional group. Out of 3 studies that assessed timeliness to intervention, one reported shorter time associated with the hybrid OT, while the other two reported no difference. Mortality outcomes were reported in 4 studies and showed no significant difference associated with treatment in the hybrid OT. Two studies revealed shorter total procedure times associated with the hybrid OT. Two out of 3 studies that evaluated blood transfusion requirements reported decreased transfusion rates in the hybrid OT group. Only 1 study examined complication rates and demonstrated morbidity benefits associated with the hybrid OT.
Establishment of a hybrid OT requires a significant capital investment as well as a highly functioning multi-disciplinary team. The cost-benefit ratio remains unclear. Future studies, preferably in the form of clinical trials, are required to evaluate its usefulness in improving timeliness to definitive haemorrhage control and outcomes in severe trauma.
杂交手术室（OT）允许同时进行介入放射学和手术操作，为严重受伤患者的治疗提供一站式服务。几个国家已经采用了杂交 OT 的使用，但它们在提高效率和护理质量方面的临床影响尚不清楚。本研究系统地回顾了杂交 OT 在严重创伤治疗中的临床影响。
对 PubMed、Embase 和 Cochrane 数据库进行文献回顾，以确定从 2000 年 1 月 1 日至 2020 年 12 月 31 日发表的所有英文文章，报道了杂交 OT 对严重创伤的影响。还对文章进行了参考资料的审查。
共筛选出 5 篇报告杂交 OT 临床影响的文章，共 951 例患者。这些研究均为队列研究，比较了杂交 OT 与传统组患者的结局。有 3 项研究评估了干预的及时性，其中 1 项报告了杂交 OT 相关的时间更短，而另外 2 项报告无差异。有 4 项研究报告了死亡率结局，且在杂交 OT 治疗中无显著差异。有 2 项研究显示杂交 OT 相关的总手术时间更短。有 3 项研究中的 2 项评估了输血需求，报告了杂交 OT 组输血率降低。只有 1 项研究检查了并发症发生率，并证明了杂交 OT 的发病率益处。
建立杂交 OT 需要大量的资本投资和高度运作的多学科团队。成本效益比尚不清楚。需要未来的研究，最好是临床试验，来评估其在提高严重创伤患者确定性出血控制和结局的及时性方面的有效性。
