在食道胃癌手术中教科书结局和教科书瘤结局 - 一个系统的范围审查
Jeppe S Gregersen1, Trygve U Solstad1, Michael P Achiam1
1Department of Transplantation and Digestive Diseases, Rigshospitalet, Copenhagen University Hospital, Denmark.
概括
教科书结果 (TO) 和教科书瘤结果 (TOO) 是食道胃癌手术质量的关键指标. 这次审查发现它们的定义和发病率存在很大差异,突出了提高患者存活率的标准化需求.
科学领域:
- 外科手术质量评估的质量评估
- 瘤外科手术的结果
- 胃食道癌症研究 胃食道癌症研究
背景情况:
- 质量保证在食管胃外科手术中至关重要,影响长期生存.
- 教科书结果 (TO) 和教科书瘤结果 (TOO) 是评估外科质量和瘤结果的既定指标.
- 之前的研究将TO和TOO的实现与改善患者长期存活率联系起来.
研究的目的:
- 调查食管胃瘤手术中教科书结局 (TO) 和教科书瘤结局 (TOO) 的发生率.
- 分析食道胃癌手术文献中使用的TO和TOO的各种定义.
主要方法:
- 系统性范围审查遵循PRISMA 2020指南和扩展.
- 通过Medline,Embase和Web of Science进行的搜索,通过Covidence进行查.
- 质量评估使用了纽卡斯尔-太华规模;AMSTAR-2评价了审查的质量.
主要成果:
- 包括55个观察队列研究,涉及245,075名接受食道胃癌手术的患者.
- 报告的TO成绩率差异很大 (20.4%84.2%),TO成绩也差异很大 (21.3%57.6%).
- 对TO和TOO的定义显示出显著的异质性,从总共45个不同的参数中使用了9个参数的中位数 (范围:411).
结论:
- 这次审查发现了食管胃癌手术中TO和TOO报告的发病率和定义的实质性变异.
- 这些发现强调了对TO和TOO定义的标准化至关重要,以确保一致的质量评估.
- 标准化对于准确比较手术结果和改善食道胃癌患者的长期存活率至关重要.
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