巴西一家大型大学医院血管外科培训中腔内技术的影响。

Impact of endovascular technique in vascular surgery training at a large university hospital in Brazil.

机构信息

Division of Vascular and Endovascular Surgery, University of Sao Paulo, Sao Paulo, Brazil.

出版信息

J Surg Educ. 2011 Jan-Feb;68(1):19-23. doi: 10.1016/j.jsurg.2010.08.002. Epub 2010 Nov 5.

DOI:10.1016/j.jsurg.2010.08.002

PMID:21292210

Abstract

OBJECTIVES

The aim of this study was to determine the impact of endovascular surgery versus open vascular technique training in a Brazilian teaching service.

DESIGN

Cross-sectional study.

SETTING

Hospital das Clinicas-Faculty of Medicine-University of Sao Paulo, a tertiary institutional hospital-Brazil.

PARTICIPANTS

We reviewed 1,040 arterial operations performed during 2 distinct time periods: January 1995 to December 1996, and January 2006 to December 2007. Based on the disease treated, the procedures were classified into the following 5 groups: abdominal aortic aneurysms (AAA), aorto-iliac obstructive disease (AI), obstructive disease of the femoropopliteal-tibial segment (FP), carotid disease (C), and others (O). The operations were also divided into an endovascular surgery (ES) group and an open surgery (OS) group. We compared the number of open and endovascular procedures for each arterial disease group during both periods.

RESULTS

During the 2006-2007 period, 654 patients were treated surgically, whereas over the 1995-1996 period, 386 arterial operations were performed. A significant increase in endovascular procedures (p < 0.001) was found from the 1995-1996 period to the 2006-2007 period (35 vs 351, respectively) in all groups, whereas open surgery showed a slight increase in the number of procedures in the AAA and O groups only. In the 1995-1996 period, OS was the primary surgical method for all groups, but in the 2006-2007 time frame, OS was performed more frequently than ES only in the AAA and O groups. Considering all vascular disease groups, OS was the technique used in 90.9% (351 of 386) of the operations during 1995-1996, whereas in 2006-2007, OS was performed in only 46.3% (303 of 654) of the procedures.

CONCLUSIONS

The increase in the number of ES observed over the past decade has had little impact on OS procedures performed at our medical center, not bringing harm to open surgical training.

摘要

目的

本研究旨在探讨在巴西教学医院中，腔内血管手术与开放血管技术培训的效果。

设计

横断面研究。

地点

巴西圣保罗大学附属医院（三级教学医院）。

参与者

我们回顾了 1995 年 1 月至 1996 年 12 月和 2006 年 1 月至 2007 年 12 月两个不同时期的 1040 例动脉手术。根据治疗的疾病，手术分为以下 5 组：腹主动脉瘤（AAA）、主髂动脉阻塞性疾病（AI）、股腘-胫腓段阻塞性疾病（FP）、颈动脉疾病（C）和其他（O）。手术也分为腔内血管手术（ES）组和开放手术（OS）组。我们比较了两个时期每个动脉疾病组的开放和腔内手术数量。

结果

2006-2007 年期间，654 例患者接受了手术治疗，而 1995-1996 年期间，386 例动脉手术。所有组别的腔内手术（p < 0.001）均显著增加（分别为 35 例和 351 例），而开放手术仅在 AAA 和 O 组中手术数量略有增加。在 1995-1996 年期间，OS 是所有组别的主要手术方法，但在 2006-2007 年期间，OS 仅在 AAA 和 O 组中比 ES 更频繁地进行。考虑所有血管疾病组，OS 在 1995-1996 年期间的 386 例手术中占 90.9%（351 例），而在 2006-2007 年期间，OS 在 654 例手术中仅占 46.3%（303 例）。