根据外科医生培训的结肠切除和直肠切除术的结果:一般 vs 结肠直肠外科医生
Amanda C Purdy1, Serena Murphy, Valery Vilchez
1From the Department of Surgery, University of California Irvine Medical Center, Orange, CA.
Journal of the American College of Surgeons
|March 13, 2024
概括
结肠直肠外科医生 (CRS) 在结肠切除和直肠切除方面比一般外科医生 (GS) 取得更好的结果. 医院应该优先聘请CRS专家,以提高患者安全并减少并发症.
科学领域:
- 手术成果研究的研究结果.
- 进行比较有效性分析.
- 医疗服务研究 医疗服务研究
背景情况:
- 大肠切除术和直肠切除术经常由一般外科医生 (GS) 和结直肠外科医生 (CRS) 进行.
- 手术培训的变化可能会影响患者的治疗结果.
- 了解这些差异对于优化外科护理至关重要.
研究的目的:
- 根据外科医生的专业,比较医院内选择性切除术,紧急切除术和选择性分泌术的结果.
- 确定GS和CRS之间的并发症和死亡率的潜在差异.
- 为医院工作人员提供信息和外科手术培训建议.
主要方法:
- 对接受集体切除或分体切除的成年患者的Vizient数据库 (2020-2022) 的回顾性分析.
- 排除创伤病例和死亡风险最高的患者.
- 多变量逻辑回归分析比较了GS和CRS之间的结果 (住院死亡率,并发症率).
主要成果:
- 对于选择性切除术,GS的并发症 (4.9%与3.9%) 和死亡率 (0.5%与0.2%) 比CRS更高.
- 对于紧急的切除术,GS显示的并发症 (12.1%与10.4%) 和死亡率 (5.1%与2.3%) 比CRS更高.
- 对于选择性乳腺切除术,GS的并发症 (5.3%与4.4%) 和死亡率 (0.3%与0.2%) 比CRS更高.
结论:
- 结肠直肠外科医生 (CRS) 与普通外科医生 (GS) 相比,在结肠切除和直肠切除方面表现出更好的结果.
- 缺乏CRS专家的医院应考虑招聘,以提高患者安全.
- 结直肠外科手术的专业培训与降低发病率和死亡率有关.
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