Pai M, Handa A, Hands L
Nuffield Dept of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
Eur J Vasc Endovasc Surg. 2002 Jun;23(6):524-7. doi: 10.1053/ejvs.2002.1634.
to review the results of index operations in vascular surgery and to evaluate the impact of a specialist vascular training programme on patient outcome.
we undertook a 5-year (January 1995-December 1999) review of the weekly-collected mortality and morbidity data. The total number, 30-day mortality and stroke rate of all index operations i.e. AAA repairs (ruptured and elective), carotid operations and infra-inguinal bypasses (above and below knee, elective and emergency) was recorded. The number of operations performed by trainees under supervision was recorded.
in the 5-year period 991 index operation were done of which 738 (74%) were done by trainees. Operations done by trainees were supervised by a consultant in 82% of cases with no significant effect on death or stroke rates. Overall vascular trainees performed 75% of the index operations of which 82% were supervised.
trainees under supervision performed three out of four index operations. The mortality and morbidity of index operations in our unit compared well with accepted best mortality and morbidity figures. Our unit provides good training opportunities for vascular trainees whilst maintaining satisfactory standards of patient care.
回顾血管外科初次手术的结果，并评估专业血管培训计划对患者预后的影响。
我们对每周收集的死亡率和发病率数据进行了为期5年（1995年1月至1999年12月）的回顾。记录了所有初次手术的总数、30天死亡率和中风发生率，即腹主动脉瘤修复术（破裂和择期）、颈动脉手术以及腹股沟下旁路手术（膝上和膝下，择期和急诊）。记录了在监督下由受训人员进行的手术数量。
在这5年期间，共进行了991例初次手术，其中738例（74%）由受训人员完成。受训人员进行的手术在82%的情况下由顾问监督，对死亡率或中风发生率没有显著影响。总体而言，血管外科受训人员完成了75%的初次手术，其中82%受到监督。
在监督下的受训人员完成了四分之三的初次手术。我们科室初次手术的死亡率和发病率与公认的最佳死亡率和发病率数据相比情况良好。我们科室为血管外科受训人员提供了良好的培训机会，同时保持了令人满意的患者护理标准。
