外科医生对腹壁重建 (AWR) 前期康复的看法:一个多机构调查调查
Samantha W Kerr1, William R Lorenz1, Alexis M Holland2
1Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Hernia : the journal of hernias and abdominal wall surgery
|December 19, 2025
概括
预康复改善了腹壁重建 (AWR) 的结果,但一般外科医生未充分利用它. 障碍包括对外科手术量,收入和机构支持的担忧,这些障碍妨碍了患者转诊,尽管有公认的好处.
科学领域:
- 手术成果研究的研究结果.
- 患者预康复策略 患者预康复策略
- 一般外科手术的实践实践.
背景情况:
- 预康复,包括戒烟,减肥和血糖控制,是基于证据的,可以改善腹壁重建 (AWR) 的结果.
- 虽然AWR计划越来越多地采用预康复,但其在选择性AWR中由一般外科医生 (GS) 的一致实施仍未得到充分审查.
研究的目的:
- 评估当前采用和利用率的预康复策略在执行选择性腹壁重建的普通外科医生.
- 确定影响GS在AWR实施预康复的障碍和促进者.
主要方法:
- 通过REDCap向两个三级医疗机构的全科医生进行了一项匿名18个问题的调查.
- 该调查针对GS进行修复,但不是专门的AWR计划的一部分.
- 描述性统计数据被用来分析态度,实践和感知到的机构支持,比较医院和手术体积.
主要成果:
- 响应率因机构而异 (30%和48%),28个GS总体响应.
- 所有受访者都承认吸烟,肥胖和失控糖尿病对AWR结果的负面影响.
- 不到三分之一的GS推迟了手术,因为戒烟 (32%),减肥 (29%),或血糖控制 (32%). 主要障碍包括担心手术量/收入 (25%) 和缺乏同事 (43%) 或机构支持 (53%).
结论:
- 尽管有强有力的证据和对其益处的共识,一般外科医生对AWR的预康复仍未得到充分利用.
- 诸如担心运营量,收入以及同事和机构的不充分支持等障碍严重阻碍了预康复转诊率.
- 解决这些已识别的障碍对于提高GS中预康复利用率至关重要,并最终改善AWR患者的治疗结果.
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