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首页> 外文期刊>Patient Preference and Adherence >What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital
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What should be the patient's preference regarding the choice of hospital in the case of radical cystectomy? Evaluation of early complications after open radical cystectomy in a medium and high volume setting in one hospital

机译：根治性膀胱切除术患者在选择医院方面应该优先选择什么？在一家医院中，高容量环境中进行开放性膀胱癌根治术后早期并发症的评估

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Purpose: This study compares early complications after cystectomy and urinary diversion (UD) stratified by the surgical focus and case load of two different department chairpersons in a single institution in two time periods. Creating clear data about complications that can affect the quality of life is an important tool for patients to decide whether and where to perform this extensive surgery. Hypothesis: A team of surgeons with a clear focus on pelvic surgery leads to lower complication rates in radical cystectomy. Materials and methods: Radical cystectomy was performed in two separate time periods under the patronage of two different chairmen in the same university hospital. The patient data were analyzed retrospectively and the complications 30 days after surgery were assessed using the Clavien–Dindo classification. Results: Statistical analysis showed a significant difference in the severity of complications between the two time periods, A and B, in total ( P 70 years, P ≤0.001) tumor grade (low grade, P <0.001; high grade, P ≤0.001), and UD (ileal conduit, P <0.001; neobladder, P <0.001). In a multivariable analysis, age ( P =0.031) and type of UD ( P =0.028) were determined as independent predictors for complications in period A. When joining the two periods together, the type of UD ( P =0.0417), age ( P =0.041), and the time periods (A/B) ( P <0.001) show a significant association with the presence of complications. Conclusion: This study compares for the first time surgical complications in two time periods with different case load and surgical focus in one department. Categorization shows that patients should prefer radical cystectomy in centers of excellence or a high-volume hospital in order to keep complications at the lowest possible level and thus have the highest benefit for oncologic outcome and quality of life.
机译：目的：本研究比较膀胱切除术和尿流改道（UD）后的早期并发症，该分层是根据两个机构在同一时期内两个机构主席的手术重点和病例负荷进行分层的。创建有关可能影响生活质量的并发症的清晰数据是患者决定是否以及在何处进行这项广泛手术的重要工具。假设：一组专注于骨盆手术的外科医生会导致根治性膀胱切除术的并发症发生率降低。材料和方法：在同一所大学医院的两名不同主席的光顾下，在两个不同的时间段内进行了根治性膀胱切除术。回顾性分析患者数据，并使用Clavien-Dindo分类对术后30天的并发症进行评估。结果：统计学分析显示，在两个时期（A和B）之间，在全部（P 70年，P≤0.001）肿瘤等级（低等级，P <0.001;高等级，P≤0.001）之间，并发症的严重程度存在显着差异。 ）和UD（回肠导管，P <0.001;新膀胱，P <0.001）。在多变量分析中，年龄（P = 0.031）和UD类型（P = 0.028）被确定为A期并发症的独立预测因子。将两个时期合并在一起时，UD的类型（P = 0.0417），年龄（ P = 0.041），时间段（A / B）（P <0.001）与并发症的存在显着相关。结论：本研究首次比较了两个时期不同病例负荷和一个部门的手术重点的手术并发症。分类显示，患者应首选高级中心或大容量医院中的根治性膀胱切除术，以将并发症保持在最低水平，从而对肿瘤学结局和生活质量带来最大益处。

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