Kuwabara Shota, Ishido Keita, Aoki Yuma, Yamamoto Kazuyuki, Shoji Yasuhito, Ichimura Tatsunosuke, Manase Hiroto, Hirano Satoshi
Department of Surgery, Asahikawa Red Cross Hospital, 1-1 Akebono 1-jo 1-chome, Asahikawa, Hokkaido, 070-8530, Japan.
Department of Gastrointestinal Surgery II, Faculty of Medicine, Hokkaido University, Kita 15-jo Nishi 7-chome, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
Updates Surg. 2024 Dec;76(8):2777-2785. doi: 10.1007/s13304-024-02032-w. Epub 2024 Nov 7.
The multidisciplinary team (MDT) approach has become the standard for perioperative patient care. At our institution, a multidisciplinary perioperative care team called "Surgical, Nutrition and Rehabilitation Integrated Services for Excellence Team (SUNRISE)" was established for all patients with gastrointestinal cancer undergoing surgery. This study aimed to elucidate the significance of SUNRISE as a perioperative MDT by comparing short-term postoperative outcomes before and after the introduction of SUNRISE in patients with colorectal cancer. We included 181 patients diagnosed with colorectal who underwent radical surgical resection with regional lymphadenectomy. The patients were divided into two groups: the pre-SUNRISE group, consisting of 105 patients who underwent radical colorectal surgery before the introduction of the SUNRISE, and the SUNRISE group, consisting of 76 patients who underwent radical colorectal surgery after the introduction of the SUNRISE. We compared the short-term postoperative outcomes between these two groups and analyzed the risk factors affecting postoperative complications using logistic regression models. The incidence of postoperative complications in the SUNRISE group was significantly lower than that in the pre-SUNRISE group (22.4% vs. 41.0%, p = 0.011). Multivariate analysis identified the presence of SUNRISE (odds ratio, 0.33, 95% confidence interval, 0.15-0.73, p < 0.006) as an independent risk factor for postoperative complications. The median postoperative hospital stay in the SUNRISE group was significantly shorter than that in the pre-SUNRISE group (9 vs. 11 days, p < 0.01). The MDT approach is useful for optimizing preoperative patient care and improving short-term postoperative outcomes in patients with colorectal cancer.
多学科团队（MDT）模式已成为围手术期患者护理的标准。在我们机构，为所有接受手术的胃肠道癌患者组建了一个名为“卓越手术、营养与康复综合服务团队（SUNRISE）”的多学科围手术期护理团队。本研究旨在通过比较结直肠癌患者引入SUNRISE前后的短期术后结局，阐明SUNRISE作为围手术期MDT的意义。我们纳入了181例诊断为结直肠癌并接受根治性手术切除及区域淋巴结清扫的患者。患者分为两组：SUNRISE前组，由105例在引入SUNRISE之前接受根治性结直肠癌手术的患者组成；SUNRISE组，由76例在引入SUNRISE之后接受根治性结直肠癌手术的患者组成。我们比较了两组的短期术后结局，并使用逻辑回归模型分析了影响术后并发症的危险因素。SUNRISE组术后并发症的发生率显著低于SUNRISE前组（22.4%对41.0%，p = 0.011）。多变量分析确定SUNRISE的存在（比值比，0.33，95%置信区间，0.15 - 0.73，p < 0.006）是术后并发症的独立危险因素。SUNRISE组术后住院时间中位数显著短于SUNRISE前组（9天对11天，p < 0.01）。MDT模式有助于优化结直肠癌患者的术前护理并改善其短期术后结局。
