通过下静脉卡瓦血栓切除术进行彻底腎切除术后的术后结果
Nikolaos Pyrgidis1, Gerald Bastian Schulz1, Christian G Stief1
1Department of Urology, University Hospital, Ludwig-Maximilian University, 81377 Munich, Germany.
Cancers
|April 14, 2025
概括
在下腔静脉 (IVC) 血栓切除术的根性腎切除术中,较高的年度病例数与改善的患者结局相关. 增加每家医院的外科手术量减少了主要的术后并发症和住院时间.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 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:
- 根性切除术与下腔静脉 (IVC) 血栓切除术是一项复杂的手术.
- 了解趋势和术后结果对于患者护理至关重要.
- 医院外科手术体积对结果的影响需要进一步调查.
研究的目的:
- 评估与急性切除术和IVC血栓切除术相关的当前趋势和并发症.
- 评估每年医院病例数量对术后结果的影响.
主要方法:
- 利用GeRmAn全国住院患者数据 (GRAND) 从2005年到2022年.
- 分类医院为低 (<3),中等 (3-9),高 (≥10) 的IVC血栓切除的年度病例数量.
- 分析了3608名接受该手术的患者的数据,主要是通过开放式手术.
主要成果:
- 与低体积中心相比,高体积中心的重症监护病房入院率明显较低 (29%vs45%) 和住院时间较短 (3.9天较短).
- 医院每年进行的每一个额外病例都显示了术后结果的改善,包括减少死亡率,ICU入院,急性脏病和更短的住院时间.
- 近年来,IVC血栓切除手术的根性切除术数量呈下降趋势.
结论:
- 现实世界的数据表明,每年增加的医院病例数量和IVC血栓切除术的急性切除术的改善外科治疗结果之间存在直接的相关性.
- 将复杂的程序集中到大量的中心可能会提高患者的安全性并减少并发症.
- 进一步的研究应该探索专业瘤手术的最佳病例负载值.
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