Lauter David M, Serna Salina
Institute for Laparoscopic Surgery, 12303 NE 130th Lane, #520, Kirkland, WA 98034, USA.
Am J Surg. 2003 Jul;186(1):13-6. doi: 10.1016/s0002-9610(03)00112-0.
To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery.
After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey asked about the surgeon's practice, volume of colon surgery in the preceding year, the number of laparoscopic colon resections ever performed, the surgeon's opinion on the future practice of laparoscopic colorectal surgery, and whether faced with the personal need to undergo colon resection at the present time, would the surgeon elect to have laparoscopic or open colon resection.
In all 170 surveys were returned; 154 returned surveys were from surgeons who had performed at least one colon resection in the preceding year; 53 (34%) respondents had experience with fewer than 20 laparoscopic resections and 83 (55%) have never performed laparoscopic-assisted colectomy (LAC). Only 4 (3%) surgeons had performed more than 50 laparoscopic colon resections. Forty-five percent of respondents indicated that they would currently seek a laparoscopic resection for themselves to treat either a benign condition or an incurable malignancy, and 84% of respondents indicated they would have an open colectomy for a curable malignancy.
The majority of surgeons performing colorectal resections in Washington have limited experience with LAC. Surgeon opinion regarding the role of laparoscopic colorectal surgery in clinical practice is mixed. We suggest a model for proctoring of LAC for surgeons interested in implementing laparoscopic colorectal resection into their practice.
描述华盛顿州从事结直肠手术的外科医生当前关于腹腔镜结直肠手术的实践情况和观点。
在试图确定华盛顿州所有具有结直肠手术医院权限的外科医生后,向303名外科医生发送了一份调查问卷。该问卷询问了外科医生的执业情况、上一年的结肠手术量、曾经进行的腹腔镜结肠切除术数量、外科医生对腹腔镜结直肠手术未来实践的看法,以及如果目前面临个人需要接受结肠切除术,外科医生会选择腹腔镜还是开放结肠切除术。
共返回170份调查问卷;154份返回问卷来自上一年至少进行过一次结肠切除术的外科医生;53名(34%)受访者进行腹腔镜切除术的经验少于20例,83名(55%)从未进行过腹腔镜辅助结肠切除术(LAC)。只有4名(3%)外科医生进行过50例以上的腹腔镜结肠切除术。45%的受访者表示,他们目前会为自己选择腹腔镜切除术来治疗良性疾病或无法治愈的恶性肿瘤,84%的受访者表示他们会为可治愈的恶性肿瘤进行开放结肠切除术。
华盛顿州大多数进行结直肠切除术的外科医生对LAC的经验有限。外科医生对腹腔镜结直肠手术在临床实践中的作用看法不一。我们为有兴趣在实践中开展腹腔镜结直肠切除术的外科医生提出了一种LAC指导模式。