Department of Surgery, University of Miami, Atlantis, Florida.
J Surg Educ. 2013 Nov-Dec;70(6):700-2. doi: 10.1016/j.jsurg.2013.06.019. Epub 2013 Sep 14.
Our country faces a shortage of surgeons; hence, we may anticipate the development of new surgery residencies. Therefore, the question of the effect of a new program on operating room times (ORT) is important. Our primary aim was to compare ORT of 3 common procedures done by attendings alone vs ORT of cases with residents.
We queried records of 1458 patients from the JFK Medical Center database for laparoscopic cholecystectomy, open inguinal hernia repair, and laparoscopic appendectomy from July 2010 to July 2012. We divided the sample into 2 groups: "attending alone" (2010-2011) and "with residents" (2011-2012). The ORT was calculated by "Cut time" and "Close time," as recorded in the OR. ORT for both groups was calculated using the unpaired t test.
Of the total number of patients, 778 underwent laparoscopic cholecystectomy, 407 underwent open inguinal hernia repair, and 273 underwent laparoscopic appendectomy; of these, 620, 315, and 211 procedures, respectively, were done by the attending alone and 158, 92, and 62, respectively, were done with residents. Differences in ORT for the 3 types of surgery were statistically significant (p < 0.001). There was no statistical significance when comparing the first half with the second half of the academic year for residents' ORT.
Resident involvement increases ORT. Cost analysis considering OR time and anesthesia time vs federal funding for Graduate Medical Education is complicated. The benefit of new programs in diminishing the shortage of surgeons cannot be underestimated.
我国外科医生短缺,因此我们可能会看到新的外科住院医师项目的发展。因此,新计划对手术室时间(ORT)的影响是一个重要的问题。我们的主要目的是比较单独由主治医生进行的 3 种常见手术与有住院医生参与的手术的 ORT。
我们从 JFK 医疗中心数据库中查询了 2010 年 7 月至 2012 年 7 月 1458 名接受腹腔镜胆囊切除术、开放腹股沟疝修补术和腹腔镜阑尾切除术患者的记录。我们将样本分为两组:“主治医生单独”(2010-2011 年)和“有住院医生”(2011-2012 年)。ORT 通过手术室内记录的“切开时间”和“缝合时间”来计算。使用未配对 t 检验计算两组的 ORT。
在总患者人数中,778 人接受了腹腔镜胆囊切除术,407 人接受了开放腹股沟疝修补术,273 人接受了腹腔镜阑尾切除术;其中,分别有 620、315 和 211 例手术由主治医生单独完成,158、92 和 62 例手术有住院医生参与。3 种手术的 ORT 差异有统计学意义(p<0.001)。在比较住院医生 ORT 的整个学术年度的上半年与下半年时,没有统计学意义。
住院医生的参与增加了 ORT。考虑到手术室时间和麻醉时间与联邦政府对住院医师教育拨款的成本分析很复杂。新计划在减少外科医生短缺方面的好处不容低估。