Department of Gynecology with Center of Oncological Surgery, Charité Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
Berlin Institute of Health, Berlin, Germany.
Int J Gynecol Cancer. 2022 Jun 6;32(6):746-752. doi: 10.1136/ijgc-2021-003173.
The international Charité-MAYO Conference aims to promote international dialog on diagnostics, management, scientific breakthroughs, and state-of-the-art surgical procedures in gynecology and gynecologic oncology and senology. Live surgeries are a fundamental tool of interdisciplinary and international exchange of experts in their respective fields. Currently, there is a controversial and emotional debate about the true value, risks, and safety of live surgical broadcasts. The aim of the current study is to analyze peri-operative risks in patients who were operated live during the Charité-MAYO Conferences.
Live surgeries were performed by the core Charité team consisting of gynecologic oncologic surgeons, breast and plastic surgeons, partly in collaboration with visiting gynecologic oncologic surgeons. We performed a retrospective analysis of live surgeries performed during seven Charité-MAYO Conferences from 2010 to 2019 held in Berlin, Germany. Patients' files and tumor databases were analyzed as required and patients were contacted to update their long-term follow-up.
Sixty-nine patients who were operated live were included. The types of surgery were as follows: urogynecologic procedures (n=13), breast surgery (n=21), and gynecologic oncology surgery for ovarian, uterine, vulvar or cervical cancer (n=35). Peri-operative complications were assessed according to the Clavien-Dindo classification. Despite a high rate of complete resection and the high frequency of multivisceral procedures, the rate of peri-operative complications was within the range published in the literature. Time of surgery and length of intensive unit care and hospital stay did not differ from data acquired at the home institution.
Based on our analysis, live surgeries appear to be safe when performed within a multidisciplinary setting without an increase in surgical morbidity and mortality compared with historical controls and without compromise of patients' outcome. This is the first analysis of its kind to set the basis for patient information and consent for this type of surgeries.
国际 Charité-MAYO 会议旨在促进妇科和妇科肿瘤学以及乳腺科学领域的诊断、管理、科学突破和最先进手术的国际对话。现场手术是跨学科和专家国际交流的基本工具。目前，关于现场手术直播的真正价值、风险和安全性存在着有争议且情绪化的辩论。本研究旨在分析 Charité-MAYO 会议期间现场手术患者的围手术期风险。
现场手术由 Charité 核心团队进行，成员包括妇科肿瘤外科医生、乳房和整形外科医生，部分手术与来访的妇科肿瘤外科医生合作。我们对 2010 年至 2019 年在德国柏林举行的七次 Charité-MAYO 会议期间进行的现场手术进行了回顾性分析。根据需要分析患者的病历和肿瘤数据库，并联系患者以更新其长期随访情况。
共纳入 69 例现场手术患者。手术类型如下：尿妇科手术（n=13）、乳房手术（n=21）和卵巢、子宫、外阴或宫颈癌的妇科肿瘤手术（n=35）。根据 Clavien-Dindo 分类评估围手术期并发症。尽管完全切除率高，且多脏器手术频率高，但围手术期并发症发生率与文献报道的相似。手术时间、重症监护病房和住院时间与本院数据无差异。
根据我们的分析，在多学科环境下进行现场手术似乎是安全的，与历史对照相比，手术发病率和死亡率没有增加，并且不会影响患者的预后。这是首例对其进行分析的研究，为这类手术的患者知情同意奠定了基础。
