胃がんに関する第2次ブラジルのコンセンサスの勧告の臨床実践の実施:ブラジル胃がん協会の多センター研究
Marcus Fernando Kodama Pertille Ramos1, Marina Alessandra Pereira1, Alexandre Farias de Albuquerque2
1Universidade de São Paulo, Faculty of Medicine, Hospital das Clinicas, Cancer Institute, Department of Gastroenterology - São Paulo (SP), Brazil.
まとめ
胃がんに関する第2次ブラジルのコンセンサスの勧告の半分以上は 実践されていない. 胃がん患者の改善のために 診断用腹腔鏡検査,栄養補助,リンパ節回収のガイドラインの遵守を向上させることが重要です.
科学分野:
- 腫瘍学
- 手術腫瘍学
- 胃腸内科
背景:
- 胃がん (GC) は世界的な健康問題であり,世界で3番目に致死性の高い癌です.
- 化学療法,放射線療法,手術,および最小侵襲的技術を含む多様療法戦略は,GC管理の標準です.
- 臨床ガイドラインとコンセンサス・ステートメントは GCのケアを標準化するために不可欠ですが,実際の実践と整合するには評価が必要です.
研究 の 目的:
- 胃がんに関する第2次ブラジルコンセンサスの推薦の実施レベルをブラジルのがんリファレンスセンターで評価する.
- 胃がんの管理における専門家の勧告と現在の臨床実務との間の相違点を特定する.
主な方法:
- 18のがんセンターを対象とした多中心研究で,1年以上のデータを収集した.
- 胃がんに関する第2回ブラジルのコンセンサスの21の重要な声明が評価されました.
- 適用可能なケースの80%以上で勧告に従ったと定義された.
主要な成果:
- 21件のうち11件のみ (52.4%) が準拠基準に達した.
- D2リンパ管切除と早期遠端腫瘍における最小侵襲性手術 (MIS) で高い粘着性が観察されました.
- 診断用腹腔鏡 (24. 7%) と不十分な手術前栄養療法 (42%) が認められた. D2解剖の36. 7%ではリンパ節の回収が不十分でした.
結論:
- 第2次ブラジルのコンセンサスの勧告の半分以上が 胃がんの日常的なケアで実施されています
- 改善が必要な分野には 診断用腹腔鏡検査,栄養補助,リンパ節回収,ネオアジュバント化学療法があります
- 教育と政策を通じてガイドラインの遵守を強化することは,推奨と実践の間のギャップを埋めるために不可欠であり,最終的には患者の成果を改善します.
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