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《结直肠癌手术的教科书式结局:意大利语版》

Textbook Outcome in Colorectal Surgery for Cancer: An Italian Version.

作者信息

Sofia Silvia, Degiuli Maurizio, Anania Gabriele, Baiocchi Gian Luca, Baldari Ludovica, Baldazzi Gianandrea, Bianco Francesco, Borghi Felice, Cavaliere Davide, Coco Claudio, Coppola Roberto, D'Ugo Domenico, Delrio Paolo, Fumagalli Romario Uberto, Guerrieri Mario, Milone Marco, Morino Mario, Muratore Andrea, Navarra Giuseppe, Pedrazzani Corrado, Persiani Roberto, Petz Wanda, Rosati Riccardo, Roviello Franco, Scabini Stefano, Sica Giuseppe, Solaini Leonardo, Spinelli Antonino, Spolverato Gaya, Urso Emanuele, Reddavid Rossella

机构信息

Department of Oncology, Division of Surgical Oncology and Digestive Surgery, San Luigi University Hospital, University of Turin, 10043 Turin, Italy.

Dipartimento Scienze Mediche, Università di Ferrara, 44121 Ferrara, Italy.

出版信息

J Clin Med. 2024 Aug 9;13(16):4687. doi: 10.3390/jcm13164687.

Abstract

: The textbook outcome (TO) is a composite tool introduced to uniform surgical units and regulate surgical quality and outcomes. A patient is considered TO only if all predetermined items are met. In colorectal surgery, TO represents a new tool that can achieve important results given the prevalence of colorectal cancers. However, at present, there is a lack of uniformity in the TO's definition. This study utilized the Delphi process to define an Italian version of the TO in colorectal cancer. : The survey consisted of two rounds of online questionnaires submitted to an expert panel in colorectal oncological surgery, renowned academic surgeons, who had attended multiple scientific conferences and who were authors of papers on this specific topic. Five main topics with 26 questions were investigated through an online modified Delphi method. Items with almost 75% agreement achieved consensus. : Twenty-eight Italian experts were selected and participated in the two rounds. The Italian version of the textbook outcome in colorectal surgery was defined as the presence of 90-day postoperative survival, negative margins and at least 12 lymph nodes, a minimally invasive approach, ostomy fashioning if preoperatively planned, postoperative complication < Clavien-Dindo 3b, at least 10 ERAS items, no readmission, proper CHT and RT regimens, complete colonoscopy after or before surgery and Tumor Board Evaluation. : The textbook outcome in colorectal cancer patients is a quality instrument providing a complete overview of the care of such patients, from diagnosis to treatment. We hereby propose an Italian version of the TO with outcomes chosen by an expert panel.

摘要

教科书式结局(TO)是一种引入统一手术单元以规范手术质量和结果的综合工具。只有当所有预定项目均满足时,患者才被视为达到教科书式结局。在结直肠手术中,鉴于结直肠癌的患病率,教科书式结局是一种能够取得重要成果的新工具。然而,目前教科书式结局的定义缺乏统一性。本研究利用德尔菲法来定义意大利版的结直肠癌教科书式结局。该调查包括两轮在线问卷,问卷提交给了结直肠肿瘤外科专家小组,这些专家是著名的学术外科医生,他们参加过多次科学会议且是关于该特定主题论文的作者。通过在线改良德尔菲法对五个主要主题的26个问题进行了调查。达成近75%共识的项目获得了一致意见。28名意大利专家被选中并参与了这两轮调查。意大利版结直肠手术教科书式结局被定义为具备术后90天生存、切缘阴性且至少有12个淋巴结、采用微创方法、若术前计划则进行造口成形、术后并发症<Clavien-Dindo 3b级、至少10项加速康复外科(ERAS)项目、无再次入院、适当的化疗(CHT)和放疗(RT)方案、手术前后进行完整的结肠镜检查以及肿瘤多学科讨论评估。结直肠癌患者的教科书式结局是一种质量工具,能全面概述此类患者从诊断到治疗的护理情况。我们在此提出由专家小组选定结局的意大利版教科书式结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/08b2/11355911/5e80b360e181/jcm-13-04687-g001.jpg

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