Pearce L, Bunni J, McCarthy K, Hewitt J
Manchester Royal Infirmary , Manchester , UK.
Cheltenham General Hospital , Cheltenham , UK.
Ann R Coll Surg Engl. 2016 Jul;98(6):367-70. doi: 10.1308/rcsann.2016.0180. Epub 2016 Jun 6.
Introduction Many older surgical patients are exposed to high risks of morbidity and mortality when undergoing both elective and emergency surgery. Methods We provide an overview of perioperative care teams and the educational opportunities available to surgeons who undertake surgery in the older person. Findings The number of older people undergoing surgery is increasing at a rate faster than the proportion of older people in the overall population. Management of the older surgical patient throughout the surgical pathway forms part of the Specialty Training Curriculum for Geriatric Medicine. While 'surgery in childhood' continues to form part of the general surgical higher training syllabus, surgery in the later years of life does not. There are limited postgraduate courses and training opportunities currently available to surgeons in this field. There is clear societal need to address perioperative care for older surgical patients, which has proved successful in some centers. Moreover, surgical trainees support the inclusion of geriatric medicine issues into their training. Conclusions The ageing population requires a multidisciplinary perioperative approach, with dedicated and appropriately trained clinicians and allied health care professionals to improve outcomes.
引言 许多老年外科患者在接受择期和急诊手术时面临着较高的发病和死亡风险。方法 我们概述了围手术期护理团队以及为从事老年患者手术的外科医生提供的教育机会。研究结果 接受手术的老年人数量的增长速度快于老年人在总人口中的比例。在整个手术过程中对老年外科患者的管理是老年医学专科培训课程的一部分。虽然“儿童手术”仍是普通外科高级培训大纲的一部分,但老年手术却并非如此。目前该领域的外科医生可获得的研究生课程和培训机会有限。社会显然需要关注老年外科患者的围手术期护理,这在一些中心已被证明是成功的。此外,外科实习生支持将老年医学问题纳入他们的培训。结论 老龄化人口需要多学科的围手术期方法,配备有专门知识且经过适当培训的临床医生和专职医疗保健专业人员,以改善治疗结果。