Hoag Nathan A, Flannigan Ryan, Macneily Andrew E
Department of Urologic Sciences, Division of Pediatric Urology, University of British Columbia, Vancouver, BC.
Can Urol Assoc J. 2014 Jan-Feb;8(1-2):36-8. doi: 10.5489/cuaj.1497.
The introduction and advancement of minimally invasive surgery (MIS) has resulted in a reciprocal decline in exposure to open surgery during urology residency training. We propose organ procurement surgery as a potential vehicle to facilitate an increase in open surgical experience among trainees. We define the surgical case volume for organ procurement surgeries currently performed by urology residents in Canada, and determine what capacity exists for expansion.
Data on organ procurement surgeries were extracted for Canadian urology residents case-logs between 2005 and 2009. Case-logs were anonymously analyzed through the voluntary self-reporting program T-Res (Resilience Software Inc.). National deceased organ donor data were obtained from the Canadian Institute for Health Information.
The graduating Canadian urology resident has performed an average of 0.95 organ procurement surgeries during 5 years of training. An average of 469.6 procurement surgeries were performed yearly in Canada between 2005 and 2009. The theoretical capacity exists for each graduating resident to perform an additional 16.3 organ procurements during residency.
With the establishment of MIS as standard of care for many urologic surgeries, the decrease in open operative experience is concerning. Innovative ways to enrich open surgical experience may be required, and increased formal incorporation of organ procurements into urology residency training curriculum may help fill the void.
微创手术(MIS)的引入和发展导致泌尿外科住院医师培训期间开放手术的接触机会相应减少。我们提议将器官获取手术作为增加住院医师开放手术经验的潜在途径。我们确定了加拿大泌尿外科住院医师目前进行的器官获取手术的病例数量,并确定了扩大手术量的能力。
提取了2005年至2009年加拿大泌尿外科住院医师病例记录中有关器官获取手术的数据。通过自愿自我报告程序T-Res(Resilience Software Inc.)对病例记录进行匿名分析。国家已故器官捐赠者数据来自加拿大卫生信息研究所。
加拿大泌尿外科住院医师在5年的培训期间平均进行了0.95例器官获取手术。2005年至2009年期间,加拿大每年平均进行469.6例获取手术。理论上,每位即将毕业的住院医师在住院期间还可额外进行16.3例器官获取手术。
随着微创手术成为许多泌尿外科手术的标准治疗方法,开放手术经验的减少令人担忧。可能需要创新方法来丰富开放手术经验,将器官获取手术正式纳入泌尿外科住院医师培训课程可能有助于填补这一空白。