• MeSH
• chirurgové psychologie   MeSH
• COVID-19 komplikace   mortalita   terapie   MeSH
• komunikace MeSH
• lidé MeSH
• transplantace plic MeSH
• transplantace * etika   trendy   MeSH
• získávání tkání a orgánů organizace a řízení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• rozhovory MeSH

PURPOSE OF REVIEW: There is heightened awareness and trends towards centralizing high-risk, complex surgeries such as radical cystectomy to minimize complications and improve survival. However, after nearly a decade of mandated and/or passive centralization of care, debate regarding its benefits and harms continues. RECENT FINDINGS: During the past decade, mandated and passive centralization has led to an increase in radical cystectomies performed in high-volume hospitals (HVHs) and, perhaps by high-volume surgeons (HVS), in addition to efforts to increase the uptake of multidisciplinary strategies in the management of radical cystectomy patients. Consequently, 30 and 90-day mortality rates and overall survival have improved, and major complications and transfusion rates have decreased. Factors impacting surgical quality, such as negative surgical margin(s), pelvic lymphadenectomy and/or lymph node yield rates have increased. However, current studies have not demonstrated a coadditive impact of centralization on oncological outcomes (i.e. cancer-specific and recurrence-free survival). The benefits of centralization on oncologic survival of radical cystectomy remain unclear given the varied definitions of HVHs and HVSs across studies. In fact, centralization of radical cystectomy could lead to an increase in patient load in HVHs and for HVSs, thereby leading to longer surgery waiting times, a factor that is important in the management of muscle-invasive bladder cancer. SUMMARY: The benefits of centralization of radical cystectomy with multidisciplinary management are shown increasingly and convincingly. More studies are necessary to prospectively test the benefits, risks and harms of centralization.

• MeSH
• chirurgové psychologie   MeSH
• cystektomie * MeSH
• lidé MeSH
• lymfadenektomie * MeSH
• nádory močového měchýře chirurgie   MeSH
• specializovaná centra se zvyšujícím se počtem výkonů a tím zvyšující se kvalitou léčby * MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• chirurgie organizace a řízení   statistika a číselné údaje   výchova   MeSH
• chirurgové * psychologie   MeSH
• lidé MeSH
• mínění MeSH
• průzkumy a dotazníky MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• novinové články MeSH

Despite evidence supporting the effectiveness of best practices of infection prevention and management, many surgeons worldwide fail to implement them. Evidence-based practices tend to be underused in routine practice. Surgeons with knowledge in surgical infections should provide feedback to prescribers and integrate best practices among surgeons and implement changes within their team. Identifying a local opinion leader to serve as a champion within the surgical department may be important. The "surgeon champion" can integrate best clinical practices of infection prevention and management, drive behavior change in their colleagues, and interact with both infection control teams in promoting antimicrobial stewardship.

• MeSH
• chirurgové psychologie   normy   MeSH
• dospělí MeSH
• infekce chirurgické rány prevence a kontrola   MeSH
• kontrola infekce metody   normy   MeSH
• lidé středního věku MeSH
• lidé MeSH
• zdraví - znalosti, postoje, praxe * MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Spojené státy americké MeSH

• MeSH
• chirurgie operační * MeSH
• chirurgové psychologie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• úvodní články MeSH