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Well-trained gynecologic oncologists can perform bowel resection and upper abdominal surgery safely.

训练有素的妇科肿瘤医生可以安全地进行肠切除和上腹部手术。

  • 影响因子:2.57
  • DOI:10.3802/jgo.2020.31.e3
  • 作者列表:"Nishikimi K","Tate S","Kato K","Matsuoka A","Shozu M
  • 发表时间:2020-01-01
Abstract

OBJECTIVE:This study was performed to examine the safety of bowel resection and upper abdominal surgery in patients with advanced ovarian cancer performed by gynecologic oncologists after training in a monodisciplinary surgical team. METHODS:We implemented a monodisciplinary surgical team consisting of specialized gynecologic oncologist for advanced ovarian cancer. In the initial learning period in 65 patients with International Federation of Gynecology and Obstetrics (FIGO) III/IV, a gynecologic oncologist who had a certification as a general surgeon trained 2 other gynecologic oncologists in bowel resection and upper abdominal surgery for 4 years. After the initial learning period, the trained gynecologic oncologists performed surgeries without the certificated general surgeon in 195 patients with FIGO III/IV. The surgical outcomes and perioperative complications during the 2 periods were evaluated. RESULTS:The rates of achieving no gross disease after cytoreductive surgery were 80.0% in the initial learning period and 83.6% in the post-learning period (p=0.560). The incidence of anastomotic leakage after rectosigmoid resection, symptomatic pleural effusion or pneumothorax after right diaphragm resection, and pancreatic fistula after splenectomy with distal pancreatectomy in the 2 periods were 2 of 34 (6.0%), 1 of 33 (3.0%), and 3 of 15 (20.0%) patients in the initial learning period, and 12 of 147 (8.2%), 1 of 118 (0.8%), and 11 of 84 (13.1%) patients in the post-learning period, respectively. There were no significant differences between the 2 groups (p=0.270, p=0.440, p=0.520, respectively). CONCLUSION:Bowel resection and upper abdominal surgery can be performed safely by gynecologic oncologists.

摘要

目的: 本研究旨在探讨妇科肿瘤医生在接受单科手术团队培训后对晚期卵巢癌患者进行肠切除和上腹部手术的安全性。 方法: 我们实施由妇科肿瘤专科医师组成的单科外科团队治疗晚期卵巢癌。在国际妇产科联合会 (FIGO) III/IV 的 65 例患者的初始学习期间, 一名具有普通外科医师认证的妇科肿瘤医师,对其他 2 名妇科肿瘤医师进行了 4 年的肠切除和上腹部手术培训。经过最初的学习期,经过培训的妇科肿瘤医生在 195 例 FIGO III/IV 患者中进行了没有全科医生认证的手术。评估 2 个时期的手术结果和围手术期并发症。 结果: 肿瘤细胞减灭术后无大体病变的发生率在学习初期为 80.0%,学习后为 83.6% (p = 0.560)。2 个时期直肠乙状结肠切除术后吻合口瘘、右侧膈肌切除术后症状性胸腔积液或气胸、脾切除合并胰体尾切除术后胰瘘的发生率为 34 例中的 2 例 (6.0%), 33 例患者中的 1 例 (3.0%) 和 15 例患者中的 3 例 (20.0%) 在初始学习期,学习后期间 147 例患者中的 12 例 (8.2%) 、 118 例患者中的 1 例 (0.8%) 和 84 例患者中的 11 例 (13.1%)。两组间差异无统计学意义 (p = 0.270,p = 0.440,p = 0.520)。 结论: 妇科肿瘤医师可以安全地进行肠切除和上腹部手术。

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影响因子:3.18
发表时间:2020-01-29
来源期刊:Vaccine
DOI:10.1016/j.vaccine.2019.11.019
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影响因子:4.02
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DOI:10.1128/JVI.00090-20
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