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肝包虫囊肿手术治疗的教科书式结果

Textbook outcome in the surgical treatment of liver hydatid cyst.

作者信息

Jaén-Torrejimeno Isabel, Ramia José M, López-Guerra Diego, Rojas-Holguín Adela, De-Armas-Conde Noelia, Blanco-Fernández Gerardo

机构信息

Department of HBP and Liver Transplant Surgery, Hospital Universitario de Badajoz, Spain.

Department of Surgery, Hospital Universitario de Alicante, Spain.

出版信息

Surgery. 2023 Feb;173(2):429-434. doi: 10.1016/j.surg.2022.09.020. Epub 2022 Nov 3.

Abstract

BACKGROUND

Textbook outcome is a composite measure used in surgery to define the ideal postoperative period and to assess the quality of care. The aim of this study was to analyze the incidence of textbook outcome and the factors independently associated with its achievement following surgical treatment of liver hydatid cysts.

METHODS

Retrospective cohort study of patients operated on for liver hydatid cysts between January 2006 and December 2021. Textbook outcome was achieved when all the following criteria were fulfilled: no mortality within 90 days, no major complications within 90 days, no hospital readmission within 90 days, and no prolonged hospital stay. Univariable and multivariable analyses were performed to identify factors associated with textbook outcome.

RESULTS

During the study period, 296 patients underwent surgery. Textbook outcome was recorded in 65.9% (195/296). Female gender (odds ratio 2.02; P = .010), noncomplicated cyst (odds ratio 3.97, P < .001), and radical surgery (odds ratio 2.26, P = .003) were the variables associated with a higher probability of achieving textbook outcome.

CONCLUSION

Textbook outcome may be a useful measure to assess the variations in surgical management between different centers, and to improve quality of care after liver hydatid cysts resection.

摘要

背景

教科书式结局是外科手术中用于定义理想术后阶段和评估护理质量的综合指标。本研究旨在分析教科书式结局的发生率以及肝包虫囊肿手术治疗后与其达成相关的独立因素。

方法

对2006年1月至2021年12月期间接受肝包虫囊肿手术的患者进行回顾性队列研究。当满足以下所有标准时即达成教科书式结局:90天内无死亡、90天内无重大并发症、90天内无再次入院以及无住院时间延长。进行单变量和多变量分析以确定与教科书式结局相关的因素。

结果

在研究期间,296例患者接受了手术。65.9%(195/296)的患者记录为教科书式结局。女性(比值比2.02;P = 0.010)、无并发症囊肿(比值比3.97,P < 0.001)和根治性手术(比值比2.26,P = 0.003)是与达成教科书式结局概率较高相关的变量。

结论

教科书式结局可能是评估不同中心手术管理差异以及改善肝包虫囊肿切除术后护理质量的有用指标。

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