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全国普通外科住院医师微创和开放手术经验的趋势:对手术技能课程发展的影响?

National trends in minimally invasive and open operative experience of graduating general surgery residents: implications for surgical skills curricula development?

机构信息

Department of Surgery, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.

出版信息

Am J Surg. 2011 Dec;202(6):720-6; discussion 726. doi: 10.1016/j.amjsurg.2011.06.045. Epub 2011 Oct 21.

Abstract

BACKGROUND

The aim of this study was to analyze national trends in minimally invasive and open cases of all graduating residents in general surgery.

METHODS

A retrospective analysis was performed on data obtained from Accreditation Council for Graduate Medical Education logs (1999-2008) of graduating residents from all US general surgery residency programs. Data were analyzed using Mantel-Haenszel χ(2) tests and the Bonferroni adjustment to detect trends in the number of minimally invasive and open cases.

RESULTS

Minimally invasive procedures accounted for an increasing proportion of cases performed (3.7% to 11.1%, P < .0001), with a proportional decrease in open cases. An increase in minimally invasive procedures with a proportional decrease in open procedures was noted in subcategories such as alimentary tract, abdominal, vascular, thoracic, and pediatric surgery (P < .0001).

CONCLUSIONS

The results of this study demonstrate that general surgery residents in the United States are performing a greater number of minimally invasive and fewer open procedures for common surgical conditions.

摘要

背景

本研究旨在分析全美普通外科住院医师中微创和开放手术的毕业人数趋势。

方法

对美国所有普通外科住院医师培训项目的研究生从 1999 年至 2008 年的研究生成绩评估委员会(ACGME)记录中获得的数据进行回顾性分析。使用 Mantel-Haenszel χ(2)检验和 Bonferroni 调整来分析数据,以检测微创和开放手术数量的趋势。

结果

微创手术的比例不断增加(3.7%至 11.1%,P<.0001),而开放手术的比例则相应减少。在消化道、腹部、血管、胸部和儿科手术等亚类中,微创手术的比例增加,而开放手术的比例相应减少(P<.0001)。

结论

本研究结果表明,美国普通外科住院医师在治疗常见外科疾病时,微创术式的应用比例不断增加,而开放术式的应用比例则相应减少。

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