文章：

经尿道膀胱肿瘤切除术中手术清单应用的系统性综述

A Systematic Review of the Use of Surgical Checklists in Transurethral Resection of Bladder Tumour

原文发布日期：27 October 2024

DOI: 10.3390/cancers16213626

类型: Article

开放获取: 是

英文摘要：

Context: Surgical checklists have previously been shown to improve surgical quality and patient outcomes. However, their use in transurethral resection of bladder tumour (TURBT), one of the most commonly performed urological procedures, has yet to be explored in depth. Objective: To evaluate the effect of surgical checklist implementation in TURBT on documentation quality, specimen quality, and oncological outcomes according to the existing literature. We then hope to develop an optimised TURBT checklist by identifying the most pertinent parameters for inclusion. Evidence acquisition: A literature search using PubMed was performed to identify literature pertaining to the use of surgical checklists in the context of TURBT. A systematic review was then performed on the 41 identified studies, of which six were included in the final analysis. Evidence synthesis: We explored three primary outcomes that arose from the literature, namely: (1) comprehensiveness of documentation; (2) resection quality; and (3) recurrence rates and recurrence-free survival (RFS). We found agreement in the literature that surgical checklist implementation does lead to an overall improvement in documentation. The effect of surgical checklists on resection quality and recurrence rates, however, was mixed in the literature, with some studies showing statistically significant improvements and others showing no significant change. Conclusions: There are multiple benefits to surgical checklist implementation in TURBT procedures. We propose an optimised 14-item surgical checklist that should be implemented in every TURBT report to ensure sufficient information documentation for risk stratification and post-operative management.

摘要翻译： 

背景：手术核查表已被证实能够提升手术质量与患者预后。然而，在泌尿外科最常见的手术之一——经尿道膀胱肿瘤切除术（TURBT）中，其应用价值尚未得到深入探讨。目的：基于现有文献，评估TURBT手术核查表的实施对记录完整性、标本质量及肿瘤学预后的影响，并通过筛选最相关的纳入参数，构建优化版TURBT核查表。证据获取：通过PubMed数据库检索与TURBT手术核查表相关的文献，对初步筛选的41项研究进行系统综述，最终纳入6项研究进行深入分析。证据综合：文献分析聚焦三个核心结局指标：（1）记录完整性；（2）切除质量；（3）复发率与无复发生存期（RFS）。研究发现，文献普遍认同手术核查表的实施能显著提升记录完整性。然而，核查表对切除质量及复发率的影响存在分歧：部分研究显示其具有统计学意义的改善，而另一些研究则未观察到显著变化。结论：在TURBT手术中实施核查表具有多重获益。本研究提出包含14项核心条目的优化版手术核查表，建议将其纳入所有TURBT手术报告，以确保为风险分层和术后管理提供充分的信息记录依据。

原文链接：

A Systematic Review of the Use of Surgical Checklists in Transurethral Resection of Bladder Tumour