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波兰外科医生在日常临床实践中对腹腔镜内镜手术的经验与认知。

The experience and awareness of laparoendoscopic procedures among Polish surgeons in everyday clinical practice.

作者信息

Mitura Kryspin, Dąbrowiecki Stanisław, Śmietański Maciej, Matyja Andrzej

机构信息

Department of General Surgery, Municipal Hospital, Siedlce, Poland.

Department of Nutrition and Dietetics, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2017;12(1):13-18. doi: 10.5114/wiitm.2017.66472. Epub 2017 Mar 13.

Abstract

INTRODUCTION

In 2012, a total of 56 647 inguinal hernia repairs were performed in Poland. However, the absence of a uniform hernia repair register obscures the current herniology status in Poland, especially regarding laparoendoscopic procedures.

AIM

To determine the awareness of laparoendoscopic procedures among Polish surgeons and to ascertain their everyday clinical practice.

MATERIAL AND METHODS

The data were collected at the national hernia conference in 2016, during an interactive session for surgeons with a special interest in herniology. They could respond to the survey items using the VoxVote application. All items and response options were displayed on participants' smartphones. The questions were related to transabdominal preperitoneal/totally extraperitoneal (TAPP/TEP) hernia repair. The surgeons responded to 27 questions regarding routine inguinal hernia repair. One hundred and six surgeons from all regions of Poland participated in the survey.

RESULTS

19.2% of respondents never inform patients about the possibility of performing laparoendoscopic repair. 45.2% admitted that they had referred a patient with a difficult inguinal hernia to another hospital or surgeon. Seventy-five percent stated they would be willing to perform TAPP/TEP if the reimbursement rates were more favourable. In bilateral hernias, 61.6% of the respondents perform a two-step open repair, while only 25% perform a single-stage laparoendoscopic repair of bilateral hernia. In women, only 13.3% perform laparoendoscopic hernia repairs, and 19.0% do not use mesh.

CONCLUSIONS

The skill level to perform TAPP/TEP repair is still inadequate among Polish surgeons. The absence of accurate data makes it impossible to verify whether the treatment methods used are compliant with the guidelines.

摘要

引言

2012年,波兰共进行了56647例腹股沟疝修补术。然而,由于缺乏统一的疝修补登记系统,波兰目前的疝科学状况不明,尤其是在腹腔镜手术方面。

目的

确定波兰外科医生对腹腔镜手术的认知程度,并了解他们的日常临床实践。

材料与方法

数据收集于2016年全国疝外科学术会议期间,面向对疝科学有特殊兴趣的外科医生举办的互动环节。他们可使用VoxVote应用程序回答调查问卷项目。所有项目及回答选项均显示在参与者的智能手机上。问题涉及经腹腹膜前/完全腹膜外(TAPP/TEP)疝修补术。外科医生回答了27个关于常规腹股沟疝修补术的问题。来自波兰各地区的106名外科医生参与了此次调查。

结果

19.2%的受访者从未告知患者有进行腹腔镜修补术的可能性。45.2%的受访者承认,他们曾将腹股沟疝病情复杂的患者转诊至其他医院或外科医生处。75%的受访者表示,如果报销比例更优惠,他们愿意开展TAPP/TEP手术。对于双侧疝,61.6%的受访者采用两步开放式修补术,而只有25%的受访者采用腹腔镜单阶段双侧疝修补术。在女性患者中,只有13.3%的受访者进行腹腔镜疝修补术,19.0%的受访者不使用补片。

结论

波兰外科医生开展TAPP/TEP修补术的技术水平仍不足。由于缺乏准确数据,无法核实所采用的治疗方法是否符合指南要求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8335/5397542/6ae1ff95c0a8/WIITM-12-29617-g001.jpg

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