Brown James A, Lewis Ronald W
Division of Urology, Medical College of Georgia, Augusta, GA, USA.
J Urol. 2006 Dec;176(6 Pt 1):2619-23; discussion 2623. doi: 10.1016/j.juro.2006.08.011.
We evaluated the clinical training and academic productivity of a unique minimally invasive urological oncology fellowship performed in 3-month rotations at 4 institutions.
With Georgia Cancer Coalition grant funding and institutional support a faculty urologist (JAB) completed 3-month fellowships at Thomas Jefferson University, Philadelphia in 2002, Indiana University, Indianapolis in 2003, Massachusetts General Hospital, Boston in 2003 and Henry Ford Hospital, Detroit in 2004.
The trainee operated under the direction of 8 surgeons and assisted/observed another 5. Total operative experience was 355 cases, including 53 standard laparoscopic radical prostatectomies, 100 robotic assisted laparoscopic radical prostatectomies, 30 standard (including 13 donor) and 22 hand assisted laparoscopic nephrectomies, 6 nephroureterectomies, 14 partial nephrectomies, 3 renal cyst decortications, 12 pyeloplasties, 5 adrenalectomies, 2 hand assisted laparoscopic ureterolysis procedures, 1 laparoscopic partial and 1 radical cystectomy, hand assisted laparoscopic cystectomy, robotic cystectomy, 26 open and 2 laparoscopic retroperitoneal lymph node dissections, 5 complex open bladder surgeries, 6 complex open renal surgeries and approximately 24 endoscopic laser upper tract tumor cases. Post-fellowship sequential initiation of laparoscopic renal cancer (April 2002), prostatectomy (July 2003) and donor nephrectomy (November 2003) programs was accomplished at the home institution. Academic projects were completed during each fellowship phase with 43 presented abstracts and 2 book chapters, 2 non-peer reviewed articles and 12 peer reviewed articles published to date.
A multi-institution fellowship allows serial acquisition and incorporation of a wide variety of cutting edge, minimally invasive and oncological procedures into an academic practice. It allows greater exposure to more high volume experts in varying oncological subspecialties. Clinical research and academic productivity are possible.
我们评估了一种独特的微创泌尿外科肿瘤学 fellowship 的临床培训情况和学术产出，该 fellowship 在 4 家机构进行为期 3 个月的轮转。
在佐治亚癌症联盟的资助和机构支持下，一位泌尿外科教员（JAB）于 2002 年在费城的托马斯·杰斐逊大学、2003 年在印第安纳波利斯的印第安纳大学、2003 年在波士顿的麻省总医院以及 2004 年在底特律的亨利·福特医院完成了为期 3 个月的 fellowship。
该学员在 8 位外科医生的指导下进行手术，并协助/观摩了另外 5 位医生的手术。总手术经验为 355 例，包括 53 例标准腹腔镜根治性前列腺切除术、100 例机器人辅助腹腔镜根治性前列腺切除术、30 例标准（包括 13 例供体）和 22 例手辅助腹腔镜肾切除术、6 例肾输尿管切除术、14 例部分肾切除术、3 例肾囊肿剥脱术、12 例肾盂成形术、5 例肾上腺切除术、2 例手辅助腹腔镜输尿管松解术、1 例腹腔镜部分和 1 例根治性膀胱切除术、手辅助腹腔镜膀胱切除术、机器人膀胱切除术、26 例开放和 2 例腹腔镜腹膜后淋巴结清扫术、5 例复杂开放膀胱手术、6 例复杂开放肾手术以及约 24 例内镜激光上尿路肿瘤病例。 fellowship 结束后，在学员所在机构相继启动了腹腔镜肾癌（2002 年 4 月）、前列腺切除术（2003 年 7 月）和供体肾切除术（2003 年 11 月）项目。在每个 fellowship 阶段都完成了学术项目，至今已发表了 43 篇摘要、2 章书籍内容、2 篇非同行评审文章和 12 篇同行评审文章。
多机构 fellowship 能够将一系列前沿、微创和肿瘤学手术逐步纳入学术实践。它能让学员有更多机会接触不同肿瘤亚专业领域的大量专家。临床研究和学术产出是可行的。
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