Rosenberg Jacob, Gram-Hanssen Anders, Reistrup Hugin, Baker Jason Joe
Department of Surgery, Center for Perioperative Optimization, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
J Patient Rep Outcomes. 2025 Jul 21;9(1):93. doi: 10.1186/s41687-025-00927-9.
Traditionally, surgical success in non-cancer operations, such as elective hernia repair, has been defined by clinical outcomes, including recurrence and complication rates. However, these measures do not capture the primary reason patients seek surgery: relief from symptoms and an improved quality of life. Despite the evident patient-centered goal of non-cancer surgical procedures, research has long prioritized clinical parameters over patient-reported outcomes (PROs). A shift is essential to ensure that surgical success aligns with what truly matters to patients.
Current surgical research and practice heavily rely on clinical benchmarks that do not adequately reflect patients' lived experiences. For non-cancer conditions, where surgery is elective and aims to enhance quality of life, PROs should serve as the primary indicators of success. Studies across various surgical disciplines have revealed discrepancies between clinical outcome measures and patient satisfaction, highlighting the need for validated, standardized PRO instruments. The Danish AFTERHERNIA Project exemplifies efforts to integrate PROs into surgical evaluations, utilizing digital health infrastructure to systematically capture patient experiences. Additionally, condition-specific tools, such as the Abdominal Hernia-Q, demonstrate the growing recognition of patient-centered metrics. However, the widespread implementation of PRO measurement faces challenges, including resource constraints and the need for clinician training. Addressing these barriers is important for redefining success in non-cancer surgical care.
A paradigm shift in non-cancer surgical evaluation is important. Success should be measured not only by technical outcomes but also by enhancements in patient-reported quality of life and satisfaction. Incorporating PROs into surgical research and practice is both a scientific necessity and an ethical responsibility to ensure that patient needs are addressed. Moving forward, the patient experience must become the foundation for defining surgical success in non-cancer conditions. Ultimately, the primary objective of surgical intervention should be to improve the patient's health status and overall well-being compared to their preoperative condition.
传统上，非癌症手术（如择期疝修补术）的手术成功是通过临床结果来定义的，包括复发率和并发症发生率。然而，这些指标并未体现患者寻求手术的主要原因：缓解症状和提高生活质量。尽管非癌症手术程序显然以患者为中心，但长期以来，研究一直将临床参数置于患者报告结局（PROs）之上。必须做出转变，以确保手术成功与对患者真正重要的因素相一致。
当前的外科研究和实践严重依赖临床基准，而这些基准并不能充分反映患者的实际体验。对于非癌症疾病，手术是选择性的，旨在提高生活质量，PROs应作为成功的主要指标。各个外科领域的研究都揭示了临床结果指标与患者满意度之间的差异，凸显了对经过验证的、标准化的PRO工具的需求。丹麦的AFTERHERNIA项目体现了将PROs纳入手术评估的努力，利用数字健康基础设施系统地收集患者体验。此外，特定疾病的工具，如腹疝-Q，表明对以患者为中心的指标的认识日益提高。然而，PRO测量的广泛实施面临挑战，包括资源限制和临床医生培训的需求。克服这些障碍对于重新定义非癌症手术护理的成功至关重要。
非癌症手术评估的范式转变很重要。成功不仅应以技术结果来衡量，还应以患者报告的生活质量和满意度的提高来衡量。将PROs纳入外科研究和实践既是科学的必要条件，也是确保满足患者需求的道德责任。展望未来，患者体验必须成为定义非癌症疾病手术成功的基础。最终，手术干预的主要目标应该是与术前状况相比，改善患者的健康状况和整体幸福感。
