Paajanen Hannu, Varjo Riitta
Department of Surgery, University Hospital of Kuopio, Puijonlaaksontie 2, 70210 Kuopio, Finland.
BMC Surg. 2010 Aug 4;10:24. doi: 10.1186/1471-2482-10-24.
To analyse in a prospective trial the long-term results of Lichtenstein hernioplasty performed by surgical trainees.
Training of tension-free Lichtenstein hernia operation was started in our ambulatory unit as an outpatient procedure under local anaesthesia in 1996. After performing 36 teaching operations together with residents and their supervising specialist, 281 patients were operated during 1996-2000 either by one senior consultant (n = 141) or by 12 surgical trainees (n = 140). After 10 years, 247 (88%) patients were available for the long-term assessment.
After one month postoperatively, the rate of wound infections (consultant 1.1%, residents 0.7%) and hematomas (consultant 1.1%, residents 3.0%) were low and not related to surgeon's training level (ns). Only 6 (2.1%) clinically evident recurrences were found after 10 years: two after specialist repair and four after trainee repair (ns). Although one third of the patients reported some discomfort after 3 and 10 years, 93-95% of the patients were very satisfied with the operation, with no statistical difference between the surgeons.
Ambulatory open mesh repair under local anaesthesia was a safe operation and the long-term results were acceptable among the patients operated by surgical trainees.
在一项前瞻性试验中分析外科实习生进行的利chtenstein疝修补术的长期结果。
1996年，我们的门诊部门开始将无张力利chtenstein疝手术培训作为门诊局部麻醉下的手术。在与住院医师及其指导专家共同进行36例教学手术后，1996年至2000年期间，281例患者由一名高级顾问（n = 141）或12名外科实习生（n = 140）进行手术。10年后，247例（88%）患者可进行长期评估。
术后1个月，伤口感染率（顾问医生1.1%，住院医师0.7%）和血肿率（顾问医生1.1%，住院医师3.0%）较低，且与外科医生的培训水平无关（无统计学意义）。10年后仅发现6例（2.1%）临床明显复发：专科医生修补后2例，实习生修补后4例（无统计学意义）。尽管三分之一的患者在3年和10年后报告有一些不适，但93 - 95%的患者对手术非常满意，外科医生之间无统计学差异。
局部麻醉下门诊开放网片修补术是一种安全的手术，外科实习生手术患者的长期结果是可以接受的。
