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find Keyword "手术质量" 5 results
  • Study on the Effect of Surgeon Specialization upon the Result of Radical Resection for Rectal Carcinoma

    目的 探讨医生的专业化程度对直肠癌根治性切除术质量的影响。 方法 纳入2007年7月-2009年12月收治且确诊为直肠癌的手术患者共679例,分为专业组(470例)和非专业组(209例),收集患者年龄、体质量指数(BMI)、肿瘤TNM分期、手术持续时间、术中出血量、术后胃肠功能恢复时间、术后并发症等围手术期指标,进行相关统计学分析。 结果 两组患者手术持续时间相当(P=0.322),但在专业组中患者术中出血量较非专业组少(P=0.008)。专业组患者术后拔除胃管时间(P=0.000)、拔除引流管时间(P=0.000)、首次进流质食物时间(P=0.002)、首次排便时间(P=0.007)和下床活动时间(P=0.001)均较非专业组提前,术后住院时间(P=0.152)与住院总时间(P=0.983)两组差异无统计学意义,且专业组术后并发症总发生率较低(P<0.05)。 结论 医生的专业化程度对直肠癌根治术患者围手术期的管理有显著影响,专业化程度高的直肠癌外科医生可为患者带来更好的手术效果。

    Release date:2016-09-07 02:37 Export PDF Favorites Scan
  • 专业化和手术负荷对结直肠癌手术质量的影响

    【摘要】 目前国内外学者常通过医生专业化程度、医生手术负荷量以及医院手术容量3个较为主观的指标来评价医生与医院因素对结直肠癌患者手术效果和生存预后的影响程度。这从医生和医院的角度为结直肠癌手术质量评估体系增添了新的内容,对医学生和年轻医生的培养提供了专业技能训练的指导。现就医生的专业化程度和负荷量、医院手术容量在结直肠癌手术中所起作用的研究近况进行综述。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Analysis for 76 cases of transanal total mesorectal excision and discussion on the non-patient factors affecting the quality of surgery

    ObjectiveTo analyze whether transanal total mesorectal excision (taTME) can achieve high-quality TME, explore the non-patient factors affecting the quality of taTME, improve the quality of taTME.MethodsThe clinical data of 76 patients undergoing taTME from January 2015 to September 2018 in the Department of Gastrointestinal Surgery of Nanchong Central Hospital were retrospectively analyzed. The operative time, intra-operative bleeding volume, positive rate of circumferential margin, integrity of mesorectum, positive rate of margin and complications were taken as the observation indexes of operative quality. The improvement of surgical equipment, structured training, and the accumulation of surgical cases (No. 1–25 cases was early group, No. 26–50 cases was mid-term group, No. 51–76 cases was later stage group) were compared as grouping conditions, and various factors affecting the quality of taTME were analyzed.Results① Pre- and post-the improvement of surgical equipment: compared to the pre-improvement of surgical equipment group, the distance between tumors and anal margin of patients in the post-improvement of surgical equipment was closer [(4.9±1.3) cm vs. (5.9±2.7) cm, P=0.040] and the postoperative hospital stay was shorter [(10.6±3.9) d vs. (12.4±2.7) d, P=0.023], while there were no significant difference in the amount of bleeding, the positive rate of circumferential margin, the integrity of mesorectum, the positive rate of margin and the complications in the two groups (P>0.05). ② Pre- and post-training for surgeon: compared to the pre-training group, the operative time in the post-training group was shortened [(224.6±70.2) min vs. (275±77.0) min, P=0.020], while there were no statistical differences in the amount of bleeding, the integrity of mesorectum, the difference of the positive rate of circumferential margin, the positive rate of distal margin, postoperative complications and postoperative hospital stay (P>0.05). ③ The cumulative grouping of cases: compared to the later stage group [(218.8±69.5)min], the operative time in the early group [(275.2±82.6) min] and the mid-term group [(278.8±37.5) min] were shortened with statistical difference (P=0.022, P=0.003). Moreover, compared to the early group [(12.9±2.4) d], the postoperative hospital stay in the mid-term group [(10.8±4.0) d] and the later stage group [(10.2±3.6) d] were shortened with statistical significance (P=0.032, P=0.007). However, there were no significant difference in the volume of bleeding, the positive rate of circumferential margin, the positive rate of incisal margin and the degree of mesangial integrity among the three groups (P>0.05).ConclusionstaTME can achieve high-quality TME. With the improvement of equipment, the participation of structured training and the accumulation of surgical cases, taTME achieved consistent quality in about 50 cases. The improvement of surgical equipment is the guarantee of the quality of taTME. Structured training is the key to improve the surgical quality of taTME.

    Release date:2019-06-05 04:24 Export PDF Favorites Scan
  • 第一届粤甘胸部肿瘤“丝路论坛”顺利召开

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  • The benefits of stapler tractor dissociating segmental bronchus in lung segmentectomy: A retrospective cohort study in a single center

    Objective To investigate the benefits of using a stapler tractor in the treatment of segmental bronchus during lung segmentectomy through detailed video replay analysis of surgical procedures. Methods We collected data from patients who underwent segmentectomy performed by the same surgical team in the Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University, from November 2020 to August 2023. After excluding data that lacked analysis parameters, the remaining patients were divided into four groups based on the methods used for dissociating segmental bronchus: a stapler tractor group (group A), a stapler with bronchial stretching group (group B), a stapler only group (group C), and a silk ligature group (group D). Then, we compared baseline data and videotaped surgical details across all groups. Surgical details included the success rate of one-time segmental bronchus dissociation and severance, the time taken for successful one-time dissociation and severance of the segmental bronchus, the incidence of bleeding during bronchus dissociation, the conversion rate to thoracotomy during surgery, and surgical outcomes such as total operative time, postoperative hospitalization days, postoperative thoracic drainage volume, and pulmonary air leakage rate. Results The study included 325 patients (203 in the group A, 62 in the group B, 29 in the group C, and 31 in the group D). There was no statistically significant difference in baseline data among the four groups. However, significant differences were found in terms of total operation time, postoperative hospitalization days, intraoperative blood loss, segmental bronchial stump length, postoperative air leakage rate, hemorrhage rate during segmental bronchial dissociation, and conversion to thoracotomy rate among the four groups (P<0.05). ConclusionUsing a stapler tractor for dissociating segmental bronchus in lung segmentectomy results in shorter operative time, less risk of intraoperative bleeding, and less surgical complications. This study provides valuable evaluation methodologies through the analysis of video replay surgical details, contributing to the improvement of lung segmentectomy quality.

    Release date:2024-09-20 01:01 Export PDF Favorites Scan
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