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英国和爱尔兰的腹腔镜结直肠手术——我们目前处于什么状况?

Laparoscopic colorectal surgery in Great Britain and Ireland--where are we now?

作者信息

Harinath G, Shah P R, Haray P N, Foster M E

机构信息

Singleton Hospital, Swansea, UK.

出版信息

Colorectal Dis. 2005 Jan;7(1):86-9. doi: 10.1111/j.1463-1318.2004.00682.x.

Abstract

OBJECTIVE

We aimed to gather information from the members of the Association of Coloproctology of Great Britain and Ireland (ACPGBI) to assess trends in the current practice of laparoscopic colorectal surgery.

METHODS

A postal questionnaire survey of the members of ACPGBI.

RESULTS

The response rate was 37% (200/540). Only 45 surgeons currently perform laparoscopic colorectal work in Great Britain and Ireland mainly right hemicolectomy and laparoscopic stoma formation, of these about one third practiced laparoscopy for benign colorectal conditions only. The majority (68%) of surgeons had enough resources at their place of work, but further training seemed to be a major issue. Nearly 22% of surgeons had not had any formal training. Only 50% of surgeons trained their specialist registrars. The incidence of conversion rate was not different for benign or malignant conditions and also did not appear to be related to the duration of experience. Only four surgeons had noted port a site recurrence during the past 10 years. Seventy-five percent (150/200) felt that laparoscopic colorectal work could be carried out safely in a District General Hospital.

CONCLUSION

Laparoscopic colorectal surgery was being performed by a small minority of members of the ACPGBI although more surgeons had started to work in this field in recent years. The main areas of concern appeared to be a wide variation in the range of experience as indicated by the number of operations performed and limited formal training for consultants.

摘要

目的

我们旨在收集英国和爱尔兰结直肠外科学会(ACPGBI)成员的信息,以评估当前腹腔镜结直肠手术的实践趋势。

方法

对ACPGBI成员进行邮寄问卷调查。

结果

回复率为37%(200/540)。目前在英国和爱尔兰只有45名外科医生开展腹腔镜结直肠手术,主要是右半结肠切除术和腹腔镜造口术,其中约三分之一仅对良性结直肠疾病实施腹腔镜手术。大多数(68%)外科医生在其工作地点有足够的资源,但进一步培训似乎是一个主要问题。近22%的外科医生没有接受过任何正规培训。只有50%的外科医生培训他们的专科住院医生。良性或恶性疾病的中转率并无差异,且似乎也与经验时长无关。在过去10年中,只有4名外科医生注意到有端口部位复发。75%(150/200)的人认为腹腔镜结直肠手术可以在地区综合医院安全地进行。

结论

虽然近年来有更多外科医生开始涉足该领域,但ACPGBI中只有一小部分成员开展腹腔镜结直肠手术。主要关注点似乎是手术例数所显示的经验范围差异很大,以及顾问医生接受的正规培训有限。

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