Wakasugi Masaki, Tsujimura Naoto, Nakahara Yujiro, Matsumoto Takashi, Takemoto Hiroyoshi, Takachi Ko, Nishioka Kiyonori, Oshima Satoshi
Department of Surgery, Kinki Central Hospital, 3-1 Kurumaduka, Itami, Hyogo 664-8533 Japan.
Ann Med Surg (Lond). 2017 Feb 10;15:43-46. doi: 10.1016/j.amsu.2017.02.002. eCollection 2017 Mar.
To confirm the safety and feasibility of single-incision laparoscopically assisted appendectomy (SILA) performed by resident doctors.
We retrospectively analyzed 86 consecutive patients who underwent SILA between August 2010 and August 2016 at Kinki Central Hospital. During this period, 9 residents and 6 board-certified attending surgeons performed SILA. Data on the patients' characteristics and perioperative complications were collected from their medical records.
Resident doctors operated on 55% (47/86) of patients undergoing SILA. There were no significant differences between the groups with regard to patient characteristics. Mean operative time in the resident and staff surgeon groups was 74 min and 71 min, respectively (p = 0.5). Median blood loss in both the resident and staff surgeon groups was 0 mL (p = 0.3). The rate of conversion to a different operative procedure was 4% (2/47) in the resident group and 3% (1/39) in the staff surgeon group (p = 1). All three above-mentioned procedures, two (4%, 2/47) in the resident group and one (3%, 1/39) in the staff surgeon group, were converted to multi-port laparoscopic appendectomy. The mean postoperative hospital stay was 5 days for both the resident and staff surgeon groups (p = 0.7). Perioperative complications developed in 9% (4/47) of the patients in the resident group and 21% (8/39) of the patients in the staff surgeon group (p = 0.1).
SILA performed by residents under the guidance of a staff surgeon is safe and feasible.
确认住院医生实施单孔腹腔镜辅助阑尾切除术（SILA）的安全性和可行性。
我们回顾性分析了2010年8月至2016年8月期间在近畿中央医院连续接受SILA手术的86例患者。在此期间，9名住院医生和6名获得委员会认证的主治外科医生实施了SILA手术。从患者病历中收集患者特征和围手术期并发症的数据。
住院医生为55%（47/86）接受SILA手术的患者实施了手术。两组患者在特征方面无显著差异。住院医生组和主治外科医生组的平均手术时间分别为74分钟和71分钟（p = 0.5）。住院医生组和主治外科医生组的中位失血量均为0毫升（p = 0.3）。住院医生组中转行不同手术方式的比例为4%（2/47），主治外科医生组为3%（1/39）（p = 1）。上述所有三种手术方式中，住院医生组有两例（4%，2/47），主治外科医生组有一例（3%，1/39）转行了多孔腹腔镜阑尾切除术。住院医生组和主治外科医生组的平均术后住院时间均为5天（p = 0.7）。住院医生组9%（4/47）的患者和主治外科医生组21%（8/39）的患者发生了围手术期并发症（p = 0.1）。
住院医生在主治外科医生的指导下实施SILA手术是安全可行的。
