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经直肠融合活检时,住院医师和顾问的结果相当:一项随机临床试验。

Residents and Consultants Have Equal Outcomes When Performing Transrectal Fusion Biopsies: A Randomized Clinical Trial.

机构信息

Department of Urology, Sapienza University of Rome, 00100 Rome, Italy.

出版信息

Curr Oncol. 2024 Jan 29;31(2):747-758. doi: 10.3390/curroncol31020055.

Abstract

The aim of our study was to compare the performance of residents vs. consultants in transrectal fusion prostate biopsies (FUS-PBs), as well as patient-reported comfort. Between January 2021 and October 2022, a consecutive series of patients undergoing FUS-PBs were randomized into two groups: (A) FUS-PBs performed by a consultant; (B) FUS-PBs performed by trained residents (>50 procedures). All patients underwent FUS-PBs with 12 systematic cores and 3/6 target cores. The detection rate and number of positive cores in the target lesion were compared between groups, and the patient's discomfort after the procedure was evaluated using the VAS scale. Overall, 140 patients with a median age of 72 years were enrolled. Overall, 69/140 (49.3%) presented prostate cancer and 53/69 (76.8%) presented a clinically significant cancer (Grade Group ≥ 2). Consultants presented a detection rate of 37/70 (52.9%) and residents a detection rate of 32/70 (45.7%) ( > 0.2); the mean number of positive cores in the index lesion was similar in both groups (1.5 vs. 1.1; > 0.10). In terms of the patients' experiences, the procedure was well tolerated, with a median VAS score of 2 in both groups, with no statistically significant differences. Residents showed satisfactory outcomes in terms of detection rate, procedural time, and patient comfort when performing prostate biopsies. Residents, after adequate training, can safely perform prostate biopsies.

摘要

我们的研究目的是比较在经直肠融合前列腺活检(FUS-PB)中住院医师与顾问的表现,以及患者报告的舒适度。在 2021 年 1 月至 2022 年 10 月期间,连续系列接受 FUS-PB 的患者被随机分为两组:(A)顾问进行的 FUS-PB;(B)经过培训的住院医师(>50 例)进行的 FUS-PB。所有患者均接受了 12 个系统核心和 3/6 个靶向核心的 FUS-PB。比较了两组之间靶病变的检出率和阳性核心数,并使用视觉模拟量表(VAS)评估患者术后的不适程度。总体而言,纳入了 140 名中位年龄为 72 岁的患者。总体而言,140 名患者中有 69 名(49.3%)患有前列腺癌,53 名(76.8%)患有临床显著癌症(Gleason 分组≥2)。顾问的检出率为 37/70(52.9%),住院医师为 32/70(45.7%)(>0.2);两组指数病变中的阳性核心数相似(1.5 对 1.1;>0.10)。就患者体验而言,两组的程序均耐受良好,中位数 VAS 评分为 2,无统计学差异。在进行前列腺活检时,住院医师在检出率、手术时间和患者舒适度方面表现出令人满意的结果。经过充分培训后,住院医师可以安全地进行前列腺活检。

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