Blidișel Alexandru, Roșu Mihai-Cătălin, Neamțu Andreea-Adriana, Totolici Bogdan Dan, Pop-Moldovan Răzvan-Ovidiu, Ardelean Andrei, Iovin Valentin-Cristian, Faur Ionuț Flaviu, Dehelean Cristina Adriana, Dema Sorin Adalbert, Neamțu Carmen
Department of Surgery I-Clinic of Surgical Semiotics & Thoracic Surgery, Center for Hepato-Biliary and Pancreatic Surgery, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.
Clinical County Emergency Hospital of Arad, Andrenyi Karoly Str., No. 2-4, 310037 Arad, Romania.
Cancers (Basel). 2025 Jun 18;17(12):2038. doi: 10.3390/cancers17122038.
Operating rooms represent valuable and pivotal units of any hospital. Therefore, their management affects healthcare service delivery through rescheduling, staff shortage/overtime, cost inefficiency, and patient dissatisfaction, among others. To optimize scheduling, we aim to assess preoperative evaluation criteria that influence the prediction of surgery duration for gastric cancer (GC) patients. In GC, radical surgery with curative intent is the ideal treatment. Nevertheless, the intervention sometimes must be palliative if the patient's status and tumor staging prove too advanced. A 6-year retrospective cohort study was performed in a tertiary care hospital, including all cases diagnosed with GC (ICD-10 code C16), confirmed through histopathology, and undergoing surgical treatment (N = 108). The results of our study confirm male predominance (63.89%) among GC surgery candidates while bringing new perspectives on patient evaluation criteria and choice of surgical intervention (curative-Group 1, palliative-Group 2). Surgery duration, including anesthesiology (175.19 [95% CI (157.60-192.77)] min), shows a direct correlation with the number of lymph nodes dissected (). Interestingly, the aggressiveness of the tumor based on histological grade (highly differentiated being generally less aggressive than poorly differentiated) shows differential correlation with surgery duration among curative and palliative surgery candidates. Similarly, TNM staging indicates the need for a longer surgical duration (pTNM stage IIA, IIB, and IIIA) for curative interventions in patients with less advanced stages, as opposed to shorter surgery duration for palliative interventions (pTNM stage IIIC and IV). The study quantitatively presents the resources needed for the optimal surgical treatment of different groups of GC patients, as the disease coding systems in use regard the treatment of each pathology as "standard" in terms of patient management. The results obtained are anchored in the global perspectives of surgical outcomes and aim to improve the management of operating room scheduling, staff, and resources.
手术室是任何医院中宝贵且关键的部门。因此，手术室的管理会通过重新安排手术时间、人员短缺/加班、成本效率低下以及患者不满等因素影响医疗服务的提供。为了优化手术安排，我们旨在评估影响胃癌（GC）患者手术时长预测的术前评估标准。在胃癌治疗中，根治性手术是理想的治疗方式。然而，如果患者的病情和肿瘤分期过于严重，有时手术必须采取姑息治疗。我们在一家三级护理医院进行了一项为期6年的回顾性队列研究，纳入了所有经组织病理学确诊为GC（ICD - 10编码C16）并接受手术治疗的病例（N = 108）。我们的研究结果证实，在胃癌手术候选患者中男性占主导（63.89%），同时为患者评估标准和手术干预选择（根治性 - 第1组，姑息性 - 第2组）带来了新的视角。手术时长，包括麻醉时间（175.19 [95%置信区间（157.60 - 192.77）]分钟），与清扫的淋巴结数量呈直接相关。有趣的是，基于组织学分级的肿瘤侵袭性（高分化通常比低分化侵袭性小）在根治性和姑息性手术候选患者中与手术时长呈现出不同的相关性。同样，TNM分期表明，对于病情较轻阶段的患者，根治性干预需要更长的手术时长（pTNM分期IIA、IIB和IIIA），而姑息性干预则需要较短的手术时长（pTNM分期IIIC和IV）。该研究定量呈现了不同组GC患者最佳手术治疗所需的资源，因为现行的疾病编码系统在患者管理方面将每种病理情况的治疗视为“标准”。所获得的结果基于手术结果的全局视角，旨在改善手术室安排、人员和资源的管理。
