普胸外科手术质量控制与评估体系
|
摘要
普胸外科手术质量控制涉及医疗机构的资质和设备技术条件、术前诊断评估、外科手术、术后管理、术后病理学诊断及随访等诸多环节。普胸外科手术质量标准应具备循证医学证据、有具体明确的标准和要求且能符合普遍适用的原则。精细化管理是普胸外科手术质量控制的核心理念之一,应严格遵循胸外科诊疗指南要求,建立标准临床路径的精细化管理制度,明确临床路径中各关键环节的质量标准,健全自我评价与监督检查相结合的临床质量控制体系。
Quality control of general thoracic surgery contains many links including the qualification and technical conditions of medical institutions, preoperative diagnostic system, surgery, postoperative management,pathological diagnosis and follow-up. Standards of quality control should be based on evidence-based medicine, and general rules with detailed criteria. As one of the core concepts of quality control, fine management is ought to strictly follow clinical practice guideline of thoracic surgery, to be clear with quality standards of each key link in clinical pathway,and to improve the clinical quality control system that combines self-evaluation and supervision and inspection.
Quality control of general thoracic surgery contains many links including the qualification and technical conditions of medical institutions, preoperative diagnostic system, surgery, postoperative management,pathological diagnosis and follow-up. Standards of quality control should be based on evidence-based medicine, and general rules with detailed criteria. As one of the core concepts of quality control, fine management is ought to strictly follow clinical practice guideline of thoracic surgery, to be clear with quality standards of each key link in clinical pathway,and to improve the clinical quality control system that combines self-evaluation and supervision and inspection.
引文
1 Farjah F, Detterbeck FC. What is quality, and can we define it in lung cancer?-the case for quality improvement. Transl Lung Cancer Res, 2015, 4(4):365-372.
2刘伦旭,刘雪梅.用质量控制和技术规范改善胸心血管外科临床结果——2018新春寄语.中国胸心血管外科临床杂志,2018,25(2):103-104.
3秦新裕,楼文晖.进一步重视外科质量控制.中国实用外科杂志,2016, 36(1):4-5.
4 Villamizar NR, Darrabie MD, Burfeind WR, et al. Thoracoscopic lobectomy is associated with lower morbidity compared with thoracotomy. J Thorac Cardiovasc Surg, 2009, 138(2):419-425.
5 Bilimoria KY, Phillips JD, Rock CE, et al. Effect of surgeon training, specialization, and experience on outcomes for cancer surgery:a systematic review of the literature. Ann Surg Oncol,2009,16(7):1799-1808.
6 Ellis MC, Diggs BS, Vetto JT, et al. Intraoperative oncologic staging and outcomes for lung cancer resection vary by surgeon specialty.Ann Thorac Surg, 2011, 92(6):1958-1963.
7 Luchtenborg M, Riaz SP, Coupland VH, et al. High procedure volume is strongly associated with improved survival after lung cancer surgery. J Clin Oncol, 2013, 31(25):3141-3146.
8 von Meyenfeldt EM, Gooiker GA, van Gijn W, et al. The relationship between volume or surgeon specialty and outcome in the surgical treatment of lung cancer:a systematic review and meta-analysis. J Thorac Oncol, 2012, 7(7):1170-1178.
9 Muehling BM, Halter GL, Schelzig H, et al. Reduction of postoperative pulmonary complications after lung surgery using a fast track clinical pathway. Eur J Cardiothorac Surg, 2008, 34(1):174-180.
10 Wang X, Yan S, Wang Y, et al. Surgical quality surveillance and sustaining improvement of lung cancer surgery based on standard operation procedure(SOP):experience of single surgical team.Zhongguo Fei Ai Za Zhi, 2017, 20(4):253-258.
11 Brunelli A, Kim AW, Berger KI, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery:Diagnosis and management of lung cancer, 3rd ed:American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013,143(5 Suppl):e166S-e190S.
12 Ost DE, Niu J, Elting LS, et al. Quality gaps and comparative effectiveness in lung cancer staging and diagnosis. Chest, 2014,145(2):331-345.
13 Horeweg N, Scholten ET, de Jong PA, et al. Detection of lung cancer through low-dose CT screening(NELSON):a prespecified analysis of screening test performance and interval cancers. Lancet Oncol, 2014,15(12):1342-1350.
14 Ou SH, Zell JA. Prognostic significance of the number of lymph nodes removed at lobectomy in stage I A non-small cell lung cancer. J Thorac Oncol, 2008, 3(8):880-886.
15 Osarogiagbon RU, Hilsenbeck HL, Sales EW, et al. Improving the pathologic evaluation of lung cancer resection specimens. Transl Lung Cancer Res, 2015, 4(4):432-437.
16 Peyre CG, Hagen JA, DeMeester SR, et al. The number of lymph nodes removed predicts survival in esophageal cancer:an international study on the impact of extent of surgical resection.Ann Surg, 2008,248(4):549-556.
17 Little AG, Rusch VW, Bonner JA, et al. Patterns of surgical care of lung cancer patients. Ann Thorac Surg, 2005, 80(6):2051-2056.
18 Paul S, Altorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy:a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg, 2010,139(2):366-378.
19 Freeman RK, Dilts JR, Ascioti AJ, et al. A comparison of length of stay, readmission rate, and facility reimbursement after lobectomy of the lung. Ann Thorac Surg, 2013, 96(5):1740-1745.
20 Engelhardt KE, Feinglass JM, Decamp MM, et al. Treatment trends in early stage lung cancer in the united states, 2004-2013:a timetrend analysis of the National Cancer Data Base. J Thorac Cardiovasc Surg, 2018,156(3):1233-1246.e1.
21 Bilimoria KY, Stewart AK, Winchester DP, et al. The National Cancer Data Base:a powerful initiative to improve cancer care in the United States. Ann Surg Oncol, 2008,15(3):683.
22 Brunelli A, Falcoz PE, D'Amico T, et al.European guidelines on structure and qualification of general thoracic surgery. Eur J Cardiothorac Surg, 2014, 45(5):779-786.
23 Brunelli A, Berrisford RG, Rocco G, et al. The European Thoracic Database project:composite performance score to measure quality of care after major lung resection. Eur J Cardiothorac Surg, 2009,35(5):769-774.
24 Kozower BD, O'Brien SM, Kosinski AS, et al. The Society of Thoracic Surgeons Composite Score for rating program performance for lobectomy for lung cancer. Ann Thorac Surg,2016,101(4):1379-1386.
25冷雪峰,金健,丛伟,等.成都市胸外科医疗质量控制中心体系建设实践与讨论.中国胸心血管外科临床杂志,2018, 25(6):453-457.
2刘伦旭,刘雪梅.用质量控制和技术规范改善胸心血管外科临床结果——2018新春寄语.中国胸心血管外科临床杂志,2018,25(2):103-104.
3秦新裕,楼文晖.进一步重视外科质量控制.中国实用外科杂志,2016, 36(1):4-5.
4 Villamizar NR, Darrabie MD, Burfeind WR, et al. Thoracoscopic lobectomy is associated with lower morbidity compared with thoracotomy. J Thorac Cardiovasc Surg, 2009, 138(2):419-425.
5 Bilimoria KY, Phillips JD, Rock CE, et al. Effect of surgeon training, specialization, and experience on outcomes for cancer surgery:a systematic review of the literature. Ann Surg Oncol,2009,16(7):1799-1808.
6 Ellis MC, Diggs BS, Vetto JT, et al. Intraoperative oncologic staging and outcomes for lung cancer resection vary by surgeon specialty.Ann Thorac Surg, 2011, 92(6):1958-1963.
7 Luchtenborg M, Riaz SP, Coupland VH, et al. High procedure volume is strongly associated with improved survival after lung cancer surgery. J Clin Oncol, 2013, 31(25):3141-3146.
8 von Meyenfeldt EM, Gooiker GA, van Gijn W, et al. The relationship between volume or surgeon specialty and outcome in the surgical treatment of lung cancer:a systematic review and meta-analysis. J Thorac Oncol, 2012, 7(7):1170-1178.
9 Muehling BM, Halter GL, Schelzig H, et al. Reduction of postoperative pulmonary complications after lung surgery using a fast track clinical pathway. Eur J Cardiothorac Surg, 2008, 34(1):174-180.
10 Wang X, Yan S, Wang Y, et al. Surgical quality surveillance and sustaining improvement of lung cancer surgery based on standard operation procedure(SOP):experience of single surgical team.Zhongguo Fei Ai Za Zhi, 2017, 20(4):253-258.
11 Brunelli A, Kim AW, Berger KI, et al. Physiologic evaluation of the patient with lung cancer being considered for resectional surgery:Diagnosis and management of lung cancer, 3rd ed:American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013,143(5 Suppl):e166S-e190S.
12 Ost DE, Niu J, Elting LS, et al. Quality gaps and comparative effectiveness in lung cancer staging and diagnosis. Chest, 2014,145(2):331-345.
13 Horeweg N, Scholten ET, de Jong PA, et al. Detection of lung cancer through low-dose CT screening(NELSON):a prespecified analysis of screening test performance and interval cancers. Lancet Oncol, 2014,15(12):1342-1350.
14 Ou SH, Zell JA. Prognostic significance of the number of lymph nodes removed at lobectomy in stage I A non-small cell lung cancer. J Thorac Oncol, 2008, 3(8):880-886.
15 Osarogiagbon RU, Hilsenbeck HL, Sales EW, et al. Improving the pathologic evaluation of lung cancer resection specimens. Transl Lung Cancer Res, 2015, 4(4):432-437.
16 Peyre CG, Hagen JA, DeMeester SR, et al. The number of lymph nodes removed predicts survival in esophageal cancer:an international study on the impact of extent of surgical resection.Ann Surg, 2008,248(4):549-556.
17 Little AG, Rusch VW, Bonner JA, et al. Patterns of surgical care of lung cancer patients. Ann Thorac Surg, 2005, 80(6):2051-2056.
18 Paul S, Altorki NK, Sheng S, et al. Thoracoscopic lobectomy is associated with lower morbidity than open lobectomy:a propensity-matched analysis from the STS database. J Thorac Cardiovasc Surg, 2010,139(2):366-378.
19 Freeman RK, Dilts JR, Ascioti AJ, et al. A comparison of length of stay, readmission rate, and facility reimbursement after lobectomy of the lung. Ann Thorac Surg, 2013, 96(5):1740-1745.
20 Engelhardt KE, Feinglass JM, Decamp MM, et al. Treatment trends in early stage lung cancer in the united states, 2004-2013:a timetrend analysis of the National Cancer Data Base. J Thorac Cardiovasc Surg, 2018,156(3):1233-1246.e1.
21 Bilimoria KY, Stewart AK, Winchester DP, et al. The National Cancer Data Base:a powerful initiative to improve cancer care in the United States. Ann Surg Oncol, 2008,15(3):683.
22 Brunelli A, Falcoz PE, D'Amico T, et al.European guidelines on structure and qualification of general thoracic surgery. Eur J Cardiothorac Surg, 2014, 45(5):779-786.
23 Brunelli A, Berrisford RG, Rocco G, et al. The European Thoracic Database project:composite performance score to measure quality of care after major lung resection. Eur J Cardiothorac Surg, 2009,35(5):769-774.
24 Kozower BD, O'Brien SM, Kosinski AS, et al. The Society of Thoracic Surgeons Composite Score for rating program performance for lobectomy for lung cancer. Ann Thorac Surg,2016,101(4):1379-1386.
25冷雪峰,金健,丛伟,等.成都市胸外科医疗质量控制中心体系建设实践与讨论.中国胸心血管外科临床杂志,2018, 25(6):453-457.