Milone M, Musella M, Maietta P, Bianco P, Taffuri C, Salvatore G, Milone F
G Chir. 2013 Nov-Dec;34(11-12):311-4.
The aim of our study is to evaluate which surgical procedures can be considered the ideal teaching procedure for a resident surgeon.
This is a retrospective study. A chart review was performed on all patients who underwent inguinal hernia repair, saphenectomy, excision of pilonidal sinus and hemorrhoidectomy at our institution, between September 2000 and July 2011, and have at least 1 year of follow-up. We evaluated operative time and complications comparing the results obtained by resident or attending surgeon.
We obtained a higher operative time among the procedures performed by resident surgeons for all evaluated interventions. Whereas the occurrence of complications after hernia repair and excision and primary closure of pilonidal sinus were similar in case and control subjects (p = 0,1 and p = 0,1), the occurrence of complications after hemorrhoidectomy and saphenectomy was significantly higher in the case group (p = 0,08 and p = 0,1).
Hernia repair and excision and primary closure of pilonidal sinus have to be considered the ideal teaching procedure in a residency program, giving to the young surgeon the opportunity of reach several skills that he needs to master most difficult surgical procedures. Saphenectomy and hemorrhoidectomy should be considered safe only if performed by a senior resident surgeon.
我们研究的目的是评估哪些外科手术可被视为住院医师理想的教学手术。
这是一项回顾性研究。对2000年9月至2011年7月期间在本机构接受腹股沟疝修补术、大隐静脉切除术、藏毛窦切除术和痔切除术且至少有1年随访期的所有患者进行病历审查。我们比较住院医师和主治医生的手术结果，评估手术时间和并发症情况。
对于所有评估的手术，住院医师进行的手术中手术时间更长。疝修补术、藏毛窦切除及一期缝合术后并发症的发生率在病例组和对照组中相似（p = 0.1和p = 0.1），而痔切除术和大隐静脉切除术后病例组的并发症发生率显著更高（p = 0.08和p = 0.1）。
疝修补术、藏毛窦切除及一期缝合术应被视为住院医师培训项目中的理想教学手术，能让年轻外科医生有机会掌握多种其在最难的外科手术中所需掌握的技能。大隐静脉切除术和痔切除术只有在资深住院医师进行时才应被视为安全的。
