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Analysis of the SAGES Outcomes Initiative groin hernia database.

机译：SAGES结果倡议腹股沟疝数据库的分析。

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BACKGROUND: In 1999, the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) introduced the SAGES Outcomes Initiative as a way for its members to track their own outcomes. It contains perioperative and postoperative data on nearly 20,000 operations. This report provides a descriptive analysis of the groin hernia database. METHODS: The SAGES Outcomes Initiative database was accessed for all groin hernia cases from September 1999 to February 2005. The data from the preoperative, intraoperative, and postoperative entries were summarized. These data are purely descriptive and no statistical analysis was done. RESULTS: The hernia registry contains 1,607 entries, with 1,070 follow-up entries. Males comprised 85% of patients, 63% were employed, 62% had at least one comorbidity, with 84% ASA class I or II. Primary, unilateral hernia accounted for 86% of cases, whereas 14% were recurrent, 11% bilateral, 6% incarcerated, and 3% required emergency repair. The operating surgeon was the attending surgeon in 83% of cases. Anesthetic techniques were general anesthesia in 74% of cases, regional in 7%, and local in 34%, with only 16% of cases local only. Most patients had symptomatic hernias and symptoms were improved in more than 95% of patients. Most repairs were open, although 45% were endoscopic. The most frequently cited postoperative event was significant bruising (6%), with more than 99% of complications being class I or II. More than 95% of patients were able to return to work by the first postoperative visit. Patients who underwent endoscopic repair were reported to have fewer days of narcotic use than patients undergoing open repairs (0 vs 3). CONCLUSIONS: First analysis of the SAGES Outcomes Initiative groin hernia database demonstrates that (a) this is one of the largest prospective; voluntary hernia registries; (b) missing data are infrequent; and (c) the data are similar to published data from national, mandatory registries and randomized trials. Although the SAGES Outcomes Initiative is a voluntary registry, initially designed for surgeon self-assessment, and it therefore has the potential for methodological concerns inherent to voluntary registries, the findings from this first analysis are encouraging. Efforts are ongoing to simplify data entry (PDA), refine data parameters, increase surgeon participation, and determine the role of data audit and thereby the potential for clinical research.
机译：背景：1999年，美国胃肠内镜外科医师学会（SAGES）提出了SAGES结果倡议，作为其成员追踪其自身结果的一种方式。它包含有关近20,000例手术的围手术期和术后数据。该报告提供了腹股沟疝数据库的描述性分析。方法：访问1999年9月至2005年2月所有腹股沟疝病例的SAGES结果倡议数据库。总结了术前，术中和术后条目的数据。这些数据仅是描述性的，没有进行统计分析。结果：疝气注册表包含1,607个条目，并包含1,070个后续条目。男性占85％的患者，63％的雇员，62％的患者至少患有一种合并症，其中84％的ASA为I级或II级。原发性单侧疝占病例的86％，而复发性病例为14％，双侧疝为11％，被监禁为6％，需要紧急修复的为3％。在83％的病例中，手术外科医生是主治医生。麻醉技术为全身麻醉74％，局部麻醉7％，局部麻醉34％，仅局部麻醉16％。大多数患者有症状性疝气，并且超过95％的患者症状得到改善。大多数修补是开放式的，尽管有45％是内窥镜检查的。最常被引用的术后事件是严重瘀伤（6％），其中超过99％的并发症为I级或II级。超过95％的患者能够在首次术后就诊时恢复工作。据报道，接受内窥镜修复的患者使用麻醉的天数少于进行开放式修复的患者（0 vs 3）。结论：对SAGES结果倡议腹股沟疝数据库的首次分析表明：（a）这是最大的前瞻性研究之一;自愿疝气登记处; （b）丢失的数据很少; （c）数据与国家强制性注册和随机试验的公开数据相似。尽管SAGES成果计划是一个自愿注册机构，最初是为外科医生的自我评估而设计的，因此它有可能引起自愿注册机构固有的方法论问题，但首次分析的结果令人鼓舞。正在努力简化数据输入（PDA），优化数据参数，增加外科医生的参与并确定数据审核的作用，从而确定临床研究的潜力。

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