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在瑞典,膀癌的囊切除术 - - 集中化后的短期结果
Fredrik Liedberg1, Oskar Hagberg2, Firas Aljabery3
1Department of Urology Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden. fredrik.liedberg@med.lu.se.
Scandinavian journal of urology
|April 30, 2024
概括
在瑞典集中激进囊切除术 (RC) 改善了结果. 在中心化后,较少的患者经历了重新手术或90天死亡率,即使是接受护理的老年,病情更严重的患者.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 膀癌的激进囊切除术 (RC) 具有重大风险.
- 在瑞典,RC医院的整合旨在提高护理质量.
- 囊切除术护理的区域集中在2017年实施.
研究的目的:
- 评估囊切除护理集中对短期结果的影响.
- 为了比较集中化之前和之后的并发症率和死亡率.
主要方法:
- 使用了瑞典国家泌尿膀癌症登记处 (SNRUBC) 的数据.
- 分析了RC手术的90天并发症和结果.
- 数据分层分为中心化前 (2012-2016) 和中心化后 (2017-2023) 时期.
主要成果:
- 在中心化后,患者的中位数年龄和并发病率 (ASA 3或4) 增加.
- 高度并发症 (克拉维恩3至4级) 从21%降至17%,高度并发症从21%降至17%.
- 90天重新手术率从12%降至8%,90天死亡率从4%降至3% (p < 0.001).
结论:
- 在瑞典,RC护理的集中化导致了患者治疗结果的改善.
- 老年患者和具有较高并发症的患者在集中治疗后接受治疗.
- 在没有增加等待时间的情况下,观察到重新手术和死亡率的减少.
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