Effect of Multidisciplinary Board on The Diagnosis and Treatment of Endocrine Diseases

Öz

Objective: We aimed to evaluate the outcomes of our multidisciplinary endocrine board (MEB) which is established for more specific treatment management of the patients with endocrine gland diseases.

Material and Methods: The MEB is established at 2012 in our institution. Prior to this date, the setup of board was a general tumor board (GTB) in which mostly malignant cases were discussed. The records of GTB rounds from January 2009 to September 2012, the records of MEB rounds from September 2012 to December 2014 and the endocrine surgery cases performed at our department since 2009 were retrospectively analyzed and compared.

Results: A total of 1012 patients were included the study. In GTB period, 336 patients, in MEB period, 599 patients underwent surgery for endocrine diseases. Only 94 of these patients who underwent surgery were discussed at GTB, dispite that, 582 cases were discussed at MEB (p<0.001). Benign, suspicious or malignant thyroid gland diseases (n=396) were most commonly discussed (68%) at MEB. The total number of surgery for endocrine cases, thyroid, parathyroid and adrenal gland diseases were increased after the establishment of the MEB (p=0.06, p=0.13, p=0.04 and p=0.09, respectively) when compared with GTB. Also the number of surgery for thyroid cancer and the requirement of prophylactic and therapeutic neck dissection were increased (p=0.10 and p=0.03, respectively).

Conclusion: In a field as complex as endocrine diseases, a special board should increase the quantity of more sophisticated cases, as well as the quality and effectiveness of disease management rather than a GTB.

Anahtar Kelimeler

• Endocrine system diseases,Interdisciplinary communication,Specialty boards

Multidisipliner Kurulun Endokrin Hastalıkların Tanı Ve Tedavisine Etkisi

Öz

Amaç: Endokrin bez hastalığı olan hastalara daha spesifik tedavi yönetimi sağlanabilmesi amacı ile kurulmuş olan multidisipliner endokrin kurulumuza (MEK) ait sonuçlarımızı paylaşmayı amaçladık.

Gereç ve Yöntem: Kurumumuzda MEK 2012 yılında kurulmuştur. Bu tarihten önce, konseyin şekli genel tümör kurulu (GTK) olup, daha çok habis olgular tartışılmakta idi. Ocak 2009 -Eylül 2012 yıllarına ait GTK, Ekim 2012 – Aralık 2014 yıllarına ait MEK kayıtları ve kliniğimizde 2009 yılından beri ameliyat edilen endokrin cerrahi olgularına ait tıbbi kayıtlar retrospektif olarak değerlendirildi ve karşılaştırıldı.

Bulgular: Toplam 1012 hasta çalışmaya dahil edildi. GTK döneminde 336 hasta, MEK döneminde 599 hasta endokrin hastalıklar nedeniyle ameliyat edildi. Ameliyat edilen hastalardan 94’ü GTK’unda tartışılırken, 582’si MEK’unda tartışıldı (p<0,001). MEK’de çoğunlukla selim, şüpheli veya malign tiroid bezi hastalıkları (n=396) tartışıldı (%68). Tüm endokrin olgular, tiroid, paratroid ve adrenal gland hastalıkları için ameliyat sayıları MEK’unun kurulmasından sonra arttı (p=0,06; p=0.13; p=0,04 ve p=0,09, sırasıyla). Aynı zamanda, tiroid kanseri ameliyatı sayısı ve profilaktik veya terapötik boyun diseksiyonu gereksinimi de arttı (p=0,10 ve p=0,03, sırasıyla).

Sonuç: Endokrin hastalıklar gibi kompleks bir alanda, GTK’una kıyasla özel bir kurul daha sofistike olguların sayısını, aynı zamanda hastalık yönetiminin kalite ve verimini arttırabilir.

Anahtar Kelimeler

• Endokrin sistem hastalıkları,disiplinler arası iletişim,özel kurullar

Kaynakça

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