Health care quality in hepatic surgery

A multi-disciplinary effort

  • Karina Rando Hospital Central de las Fuerzas Armadas, Servicio de Cirugía Hepática y Trasplante, Sub Jefey Coordinadora de Anestesia
  • Martín Harguindeguy Universidad de la República, Facultad de Medicina, Clínica Quirúgica, Profesor Adjunto
  • Alejandro Leites Hospital Central de las Fuerzas Armadas, Servicio de Cirugía Hepática, Jefe
  • Alejandro Ettlin Hospital Central de las Fuerzas Armadas, Cirujano Hepato-Bilio Pancreático
  • Graciela Zunini Universidad de la República, Facultad de Medicina, Anestesiología, Profesor Agregado
  • Solange Gerona Hospital Central de las Fuerzas Armadas, Hepatología, Jefa

Abstract

Morbidity and mortality have classically constituted the most used quality indicators in different areas of health, including anesthesia and surgery. In liver surgery, mortality has declined significantly in recent years, for example, from figures from 25% to 0% (1), and the incidence of morbidity varies between 22% and 47% (1). With advances in anesthesiology and surgery, hepatectomies are usually performed without exceeding the aforementioned risks, so the evaluation based on mortality and morbidity is insufficient and not very sensitive today. It is not enough for patients to survive liver surgery without sequelae, but it is necessary to reach other more demanding quality standards to establish national or regional reference centers.

References

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(2) Hevesi ZG, Lopukhin SY, Mezrich JD, Andrei AC, Lee M. Designated liver transplant anesthesia team reduces blood transfusion, need for mechanical ventilation, and duration of intensive care. Liver Transpl 2009; 15(5): 460-5.
(3) Choti MA, Bowman HM, Pitt HA, Sosa JA, Sitzmann JV, Cameron JL, et al. Should hepatic resections be performed at high-volume referral centers? J Gastrointest Surg 1998; 2(1): 11-20.
(4) Tiernan J, Briggs CD, Irving GR, Swinscoe MT, Peterson M, Cameron IC. Evaluation of the introduction of a standardised protocol for the staging and follow-up of colorectal cancer on resection rates for liver metastases. Ann R Coll Surg Engl 2010; 92(3): 225-30.
(5) Rando K, Harguindeguy M, Leites A, Ettlin A, González S, Scalone P, et al. Indicadores de calidad en cirugía hepática: influencia del trabajo en equipo multidisciplinario y del "efecto centro". Acta Gastroenterol Lat 2010; 40(1): 10-21.
Published
2010-06-30
How to Cite
1.
Rando K, Harguindeguy M, Leites A, Ettlin A, Zunini G, Gerona S. Health care quality in hepatic surgery. Rev. Méd. Urug. [Internet]. 2010Jun.30 [cited 2024May18];26(2):117-9. Available from: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/436
Issue
Vol 26 No 2 (2010): Revista Médica del Uruguay
Section
Letters to the Editor
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