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印度南部一家三级护理中心子宫内膜癌患者外科护理对欧洲妇科肿瘤学会(ESGO)质量指标的依从性

Compliance of Surgical Care in Patients with Carcinoma Endometrium in a Tertiary Care Centre in South India, to European Society of Gynaecologic Oncology (ESGO) Quality Indicators.

作者信息

Thiagarajan Monica, Thomas Vinotha, Sebastian Ajit, Thomas Dhanya Susan, Chandy Rachel, Daniel Sherin, Ram Thomas Samuel, Thomas Anitha

机构信息

Department of Gynaecologic Oncology, Christian Medical College, Vellore, Tamil Nadu India.

Department of Pathology, Christian Medical College, Vellore, Tamil Nadu India.

出版信息

Indian J Surg Oncol. 2024 Sep;15(3):557-562. doi: 10.1007/s13193-024-01954-6. Epub 2024 May 10.

Abstract

To analyse the compliance of surgical care provided to patients diagnosed with carcinoma endometrium, to the European Society of Gynaeacological Oncology (ESGO) quality indicators. This is a retrospective audit done in the Department of Gynaecologic Oncology. Electronic medical records of patients who underwent surgical management of carcinoma endometrium from January 2020 to December 2021 were assessed. A total of 163 patients had undergone primary surgery, and 2 patients had surgery for recurrence. The audit showed that the target for categories of general indicators and pre-operative work-up was met. There was lack in compliance to the intraoperative management, with only 34% among presumed early-stage disease undergoing successful MIS, 31% undergoing sentinel lymph node procedure and 53% among them being done using indocyanine green with 18% bilateral mapping rate. None of the patients had complete molecular classification. Compliance to adjuvant treatment provided was adequate. Minimal required elements in surgical reports were in 81% and pathological reports in 91% of patients falling short of the set target. The audit helped us identify the need to increase MIS and use and adapt sentinel lymph node procedure with ICG dye more aggressively. There also is a need for improvement in documentation of pertinent information on surgical and pathology reporting. Molecular classification should be routinely incorporated into the diagnostic algorithm to aid in adjuvant therapy.

摘要

分析针对被诊断为子宫内膜癌的患者所提供的手术治疗对欧洲妇科肿瘤学会(ESGO)质量指标的依从性。这是在妇科肿瘤学部门进行的一项回顾性审计。评估了2020年1月至2021年12月期间接受子宫内膜癌手术治疗的患者的电子病历。共有163例患者接受了初次手术,2例患者接受了复发性手术。审计表明,总体指标和术前检查类别的目标已达成。术中管理存在依从性不足的情况,在假定的早期疾病中,只有34%成功接受了微创手术,31%接受了前哨淋巴结手术,其中53%使用吲哚菁绿进行,双侧定位率为18%。没有患者进行完整的分子分类。所提供的辅助治疗的依从性足够。手术报告中所需的最少要素在81%的患者中未达到设定目标,病理报告在91%的患者中未达到设定目标。该审计帮助我们认识到需要更积极地增加微创手术的使用以及采用并适应使用吲哚菁绿的前哨淋巴结手术。在手术和病理报告中相关信息的记录方面也需要改进。分子分类应常规纳入诊断算法以辅助辅助治疗。

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本文引用的文献

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ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma.ESGO/ESTRO/ESP 子宫内膜癌管理指南。
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