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[Outcome quality in visceral surgery interventions for benign illnesses]
A H Hölscher1, C Gutschow, E Bollschweiler
1Klinik und Poliklinik für Visceral- und Gefässchirurgie, Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50931 Köln. Arnulf.Hoelscher@medizin.uni-koeln.de
Abstract:
Quality assessment of visceral surgery for benign diseases has to differentiate between early and long-term results. In the early postoperative course, general surgery-related problems are important such as postoperative bleeding, hematomas, anastomotic leakage, or lesions of anatomical structures such as the laryngeal recurrent nerve or vagus nerve. Further criteria are blood loss, postoperative pain, quality of incisional scar, and socioeconomic factors such as duration of surgery, hospital stay, inability to work, and costs. The elimination or reduction of symptoms, which were decisive for the indication for operation, can already be assessed in the early postoperative period. However, these symptoms--persistent or recurrent--and possible secondary diseases are the main criteria for the assessment of the long-term course. Important are symptomatic or asymptomatic recurrences, secondary syndromes, and quality of life. For the assessment of symptoms and quality of life, score systems (GLQI score, AFP score) have been developed and evaluated. For the assessment of the surgical results in different diseases, specific criteria have to be taken into account.