长途旅行为直肠癌护理:机构结果和患者经验
Kent J Peterson1, Melissa K Drezdzon1, Rodney Sparapani2
1Division of Colon and Rectal Surgery, Department of Surgery, Milwaukee, Wisconsin.
The Journal of surgical research
|September 12, 2024
概括
与当地患者相比,直肠癌患者长途前往大批量中心的瘤结果和生活质量类似. 然而,长途旅行带来了更高的成本,降低了监管合规性,需要有针对性的解决方案.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 有证据表明,复杂的手术,如乳腺切除术,从高容量中心中受益.
- 长途旅行对患者结果和负担的影响仍然不清楚.
研究的目的:
- 评估瘤结局,生活质量和直肠癌患者的旅行负担.
- 为了比较长距离旅行 (LTD) 和短距离旅行 (STD) 到第三级护理中心的患者之间的结果.
主要方法:
- 对102名患有局部晚期直肠癌的患者进行了回顾性研究,这些患者接受了分泌切除术.
- 对LTD (平均57.8英里) 和STD (平均12.8英里) 队列的比较.
- 对瘤结果,生活质量和自付费用的分析;卡普兰-梅尔生存分析.
主要成果:
- 在五年死亡率 (4%对4%),疾病复发率 (26%对18%) 或生活质量 (0.85对0.87) 中,LTD和STD队列之间没有显著差异.
- 在LTD队列中,切割后监测遵守率较低 (84%与96%相比).
- 在LTD群体中,住宿费 (77.1美元对0美元) 和交通费 (133.6美元对92.6美元) 显著增加.
结论:
- 长途旅行用于直肠癌前切除与与当地护理相比较的瘤结果和生活质量有关.
- 增加的旅行费用和减少的监测合规性是LTD患者的主要障碍.
- 需要采取战略来减轻与旅行有关的负担,并改善对LTD种群的监测遵守.
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