肺部恶性肿瘤手术隔离技术专家共识

Expert consensus on surgical isolation techniques for lung malignancies

目的撰写肺部恶性肿瘤手术隔离技术专家共识(以下简称《共识》)。方法通过查阅国内外文献并对相关人员进行访谈,编写《共识》初稿,编制函询表,在全国范围内遴选专家先后进行1轮函询及1轮现场论证,结合专家意见修改相应条目,评定证据等级和推荐等级,形成《共识》。结果共遴选国内胸部肿瘤外科专家及手术室护理专家18名,专家权威系数为0.87,专家对每个条目的重要性赋值为(4.92±0.23)分,变异系数为0.09~0.16;可行性赋值为(4.54±0.65)分,变异系数为0.12~0.19;专家协调系数为0.249(P<0.001)。《共识》包括手术护理人员资质、术前评估、手术设备和仪器、切口的保护、手术体腔探查、器械敷料管理、肿瘤的切除、肿瘤的取出、同期手术与重建手术、冲洗液的使用、物品清点等11个方面的内容,适用于传统开放手术、小切口手术及胸腔镜手术等。结论《共识》从肺部手术的肿瘤隔离技术出发,针对各环节制订了详细的操作规范,易于手术护理人员执行,能够指导临床实践。

Objective To form the expert consensus on surgical isolation techniques for lung malignancies.Methods By retrieving international and national literature and interviewing relevant personnel,we formulated the first draft of a consensus on surgical isolation techniques for lung malignancies and the enquiry form. Experts are selected nationwide to conduct a round of letter consultation and a round of on-site demonstration. The corresponding items were modified in accordance with the opinions of the experts,and the level of evidence and recommendation level were marked and then a final consensus was formed. Results A total of 18 thoracic surgery experts and nursing experts from tumor surgery rooms were selected;the expert authority coefficient was 0.87;expert importance of each item was 4.92 ±0.23;coefficient of variation was 0.09 to 0.16. The feasibility was 4.54 ±0.65;coefficient of variation was 0.12 to 0.19. Expert coordination coefficient was 0.249(P<0.001). The consensus includes qualifications of operating room nurses,preoperative evaluation,surgical equipment and instruments,protection of incisions,surgical cavity exploration,management of device dressings,tumor resection,tumor removal,concurrent surgery and reconstruction surgery,use of irrigation fluid,and inventory. The above 11 aspects are applicable to traditional open surgery,small incision surgery and thoracoscopic surgery. Conclusion This consensus is based on the surgical isolation techniques for lung malignancies with detailed operating specifications for each aspect,which is easy for the surgical staff to implement and can guide clinical practice.