Ramírez Backhaus Miguel, Uwe Stolzenburg Jens, Do Mihn, Dietel Ania, Ruiz-Cerdá José L, Jiménez Cruz Juan F
Servicio de Urología, Hospital Universitario La Fe, Valencia, España.
Actas Urol Esp. 2009 Mar;33(3):290-5. doi: 10.1016/s0210-4806(09)74143-9.
In most cases the learning curve of laparoscopic radical prostatectomy is not completed during the residency. This is why International Fellowship programs are becoming more popular. The aim of this paper is to evaluate the efficiency of the fellowship program of the German group.
We describe the evolution of our last fellow in the modular training program developed by the Leipzig group. We also evaluate the efficiency of this program by analyzing the results of 30 procedures performed by the fellow as first surgeon. In addition we have reviewed the literature and compared those outcomes with previous series of the clinic and other training programs.
The training programme was completed in four months. After this time, the fellow performed 30 procedures without any assistance from a tutor. 46.67% of these procedures were nerve sparing. The time average was 2 hours and 27 minutes. The programme includes lymphadenectomy in 20 patients. Two patients had positive margins, all anastomosis were tight except for one. Urethral catheter was removed on the fifth day and there were no other intraopertive or early postoperative complications. Results may be compared to previous results of other residents of the department and also of other groups where a long-term tutor program was performed.
The learning process of laparoscopic radical prostatectomy should follow a long-term tutorized model. Until the definitive expansion/development of this technique, the Leipzig Fellowship program is a complete and effective formation schedule.
在大多数情况下,腹腔镜根治性前列腺切除术的学习曲线在住院医师培训期间并未完成。这就是国际进修项目越来越受欢迎的原因。本文旨在评估德国团队进修项目的效率。
我们描述了我们最后一位进修医生在莱比锡团队制定的模块化培训项目中的进展情况。我们还通过分析该进修医生作为主刀医生完成的30例手术的结果来评估该项目的效率。此外,我们查阅了文献,并将这些结果与该诊所之前的系列手术以及其他培训项目的结果进行了比较。
培训项目在四个月内完成。在此之后,该进修医生在没有导师协助的情况下完成了30例手术。其中46.67%的手术保留了神经。平均手术时间为2小时27分钟。该项目包括对20例患者进行淋巴结清扫。2例患者切缘阳性,除1例吻合口外,其余吻合口均紧密。术后第五天拔除尿道导管,无其他术中或早期术后并发症。结果可与该科室其他住院医师以及实施长期导师指导项目的其他团队的先前结果进行比较。
腹腔镜根治性前列腺切除术的学习过程应遵循长期导师指导模式。在该技术最终得到推广/发展之前,莱比锡进修项目是一个完整且有效的培训计划。