Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, 2131 South 17th Street, PO Box 9025, Wilmington, NC, 28401, USA,
Hernia. 2014 Aug;18(4):535-42. doi: 10.1007/s10029-013-1104-9. Epub 2013 May 5.
The purpose of this study was to evaluate surgical residents' educational experience related to ventral hernias.
A 16-question survey was sent to all program coordinators to distribute to their residents. Consent was obtained following a short introduction of the purpose of the survey. Comparisons based on training level were made using χ(2) test of independence, Fisher's exact, and Fisher's exact with Monte Carlo estimate as appropriate. A p value <0.05 was considered significant.
The survey was returned by 183 residents from 250 surgical programs. Resident postgraduate year (PG-Y) level was equivalent among groups. Preferred techniques for open ventral hernia varied; the most common (32 %) was intra-abdominal placement of mesh with defect closure. Twenty-two percent of residents had not heard of the retrorectus technique for hernia repair, 48 % had not performed the operation, and 60 % were somewhat comfortable with and knew the general categories of mesh prosthetics products. Mesh choices, biologic and synthetic, varied among the different products. The most common type of hernia education was teaching in the operating room in 87 %, didactic lecture 69 %, and discussion at journal club 45 %. Number of procedures, comfort level with open and laparoscopic techniques, indications for mesh use and technique, familiarity and use of retrorectus repair, and type of hernia education varied significantly based on resident level (p < 0.05).
Exposure to hernia techniques and mesh prosthetics in surgical residency programs appears to vary. Further evaluation is needed and may help in standardizing curriculums for hernia repair for surgical residents.
本研究旨在评估外科住院医师与腹疝相关的教育经验。
向所有项目协调员发送了一份包含 16 个问题的调查,以分发给他们的住院医师。在简短介绍调查目的后,获得了同意。基于培训水平的比较使用了卡方检验、Fisher 精确检验和 Fisher 精确检验(带有蒙特卡罗估计),适当选择。p 值<0.05 被认为具有统计学意义。
该调查共收到来自 250 个外科项目的 183 名住院医师的回复。住院医师的研究生年级(PG-Y)水平在各组之间相当。开放式腹疝的首选技术不同;最常见的(32%)是在腹腔内放置网片并关闭缺损。22%的住院医师从未听说过用于疝修补的后腹膜技术,48%的住院医师未进行过该手术,60%的住院医师对网片假体产品的一般类别有些熟悉并了解。不同产品之间的网片选择、生物和合成材料有所不同。最常见的疝教育类型是在手术室进行教学(87%)、进行理论讲座(69%)和在期刊俱乐部进行讨论(45%)。手术次数、对开放式和腹腔镜技术的舒适度、网片使用和技术的适应证、对后腹膜修复的熟悉程度和使用情况以及疝教育的类型,根据住院医师的水平有显著差异(p<0.05)。
外科住院医师培训计划中对疝技术和网片假体的接触似乎存在差异。需要进一步评估,这可能有助于为外科住院医师疝修复标准化课程。