Hamaji Masatsugu, Tanaka Toru
Department of Thoracic Surgery, Kyoto University, 54 Kawaracho, Shogoin, Sakyoku, Kyoto, Japan.
Gen Thorac Cardiovasc Surg. 2013 Mar;61(3):139-42. doi: 10.1007/s11748-012-0191-3. Epub 2012 Dec 8.
The objective of the study is to review and compare two countries' thoracic surgery training programs.
Retrospective review of the first author's prospectively maintained operative case logs in two countries was performed. Each training program was established in a teaching hospital for its country's board requirement. Preoperative diagnosis, operative procedures and postoperative diagnosis were reviewed. The case volume (overall and in each category) was also reviewed. The ratio of each category and overall case volume was compared between the two programs by Chi-square test. p value was considered significant if it is <0.05.
The overall case volumes were 169 cases in the Japanese institution and 456 cases in the United States' institution. The number ratio of each category's procedures and overall procedures was as follows: pleural cases, Japan 19.2 % versus the Unites States 20.6 % (p = 0.782), pulmonary cases, Japan 72.7 % versus the United States 36.8 % (p < 0.0001), mediastinal cases, Japan 8.1 % versus the United States 8.6 % (p = 0.678), diaphragm cases, Japan 0.62 % versus the United States 13.2 % (p = 0.0001), chest wall cases, Japan 1.2 % versus the United States 3.5 % (p = 0.0858), tracheobronchial cases, Japan 1.2 % versus the United States 1.8 % (p = 0.583). Regarding the approach, the ratios of each approach and overall cases are as follows: minimally invasive approach, Japan 78.3 % versus the United States 45.8 % (p < 0.0001), reoperative cases, Japan 0.62 % versus the United States 3.1 % (p = 0.0411).
Case variety is different between the two countries. Our findings suggest that thoracic surgery training in the United States may be beneficial for Japanese medical graduates.
本研究的目的是回顾和比较两个国家的胸外科培训项目。
对第一作者在两个国家前瞻性记录的手术病例日志进行回顾性分析。每个培训项目都是在教学医院根据本国的委员会要求设立的。对术前诊断、手术操作和术后诊断进行了回顾。还对病例数量（总体和各分类）进行了回顾。通过卡方检验比较了两个项目中各分类与总体病例数量的比例。如果p值<0.05，则认为具有显著性。
日本机构的总体病例数为169例，美国机构为456例。各分类手术与总体手术的数量比例如下：胸膜病例，日本为19.2%，美国为20.6%（p = 0.782）；肺部病例，日本为72.7%，美国为36.8%（p < 0.0001）；纵隔病例，日本为8.1%，美国为8.6%（p = 0.678）；膈肌病例，日本为0.62%，美国为13.2%（p = 0.0001）；胸壁病例，日本为1.2%，美国为3.5%（p = 0.0858）；气管支气管病例，日本为1.2%，美国为1.8%（p = 0.583）。关于手术方式，各手术方式与总体病例的比例如下：微创方式，日本为78.3%，美国为45.8%（p < 0.0001）；再次手术病例，日本为0.62%，美国为3.1%（p = 0.0411）。
两个国家的病例种类不同。我们的研究结果表明，美国的胸外科培训可能对日本医学毕业生有益。
