Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Ireland.
Education Division, School of Medicine, Trinity College Dublin, Dublin, Ireland.
Br J Surg. 2016 Jan;103(1):35-42. doi: 10.1002/bjs.9925. Epub 2015 Nov 18.
Retirement policies for surgeons differ worldwide. A range of normal human functional abilities decline as part of the ageing process. As life expectancy and their population increases, the performance ability of ageing surgeons is now a growing concern in relation to patient care. The aim was to explore the effects of ageing on surgeons' performance, and to identify current practical methods for transitioning surgeons out of practice at the appropriate time and age.
A narrative review was performed in MEDLINE using the terms 'ageing' and 'surgeon'. Additional articles were hand-picked. Modified PRISMA guidelines informed the selection of articles for inclusion. Articles were included only if they explored age-related changes in brain biology and the effect of ageing on surgeons' performance.
The literature search yielded 1811 articles; of these, 36 articles were included in the final review. Wide variation in ability was observed across ageing individuals (both surgical and lay). Considerable variation in the effects of the surgeon's age on patient mortality and postoperative complications was noted. A lack of neuroimaging research exploring the ageing of surgeons' brains specifically, and lack of real markers available for measuring surgical performance, both hinder further investigation. Standard retirement policies in accordance with age-related surgical ability are lacking in most countries around the world.
Competence should be assessed at an individual level, focusing on functional ability over chronological age; this should inform retirement policies for surgeons.
全球各地的外科医生退休政策存在差异。随着年龄的增长，人类正常的功能能力会逐渐下降。随着预期寿命和人口的增加，老年外科医生的手术能力现在成为人们关注的焦点，因为这与患者的护理有关。本研究旨在探讨年龄对外科医生手术能力的影响，并确定目前将外科医生适时退休的实用方法。
我们在 MEDLINE 中使用“老龄化”和“外科医生”这两个术语进行了叙述性综述，并进行了人工挑选。修改后的 PRISMA 指南指导了文章的选择。只有探讨与年龄相关的大脑生物学变化以及老龄化对外科医生手术能力影响的文章才被纳入。
文献检索得到 1811 篇文章，其中 36 篇文章被纳入最终综述。研究发现，老龄化个体（包括外科医生和非外科医生）的能力存在广泛差异。同时，还注意到外科医生年龄对患者死亡率和术后并发症的影响存在较大差异。缺乏专门针对外科医生大脑老龄化的神经影像学研究，以及缺乏用于衡量手术能力的实际标志物，这两个因素都阻碍了进一步的研究。在全球大多数国家，都缺乏针对与年龄相关的外科医生手术能力的标准退休政策。
应根据个体的功能能力而非实际年龄来评估能力，这将为外科医生的退休政策提供信息。
