Edgington Jonathan P, Petravick Michael E, Idowu Olumuyiwa A, Lee Michael J, Shi Lewis L
1Department of Orthopaedic Surgery and Rehabilitation Medicine (J.P.E., M.J.L., and L.L.S.), Pritzker School of Medicine (M.E.P. and O.A.I.), University of Chicago, Chicago, Illinois.
J Bone Joint Surg Am. 2017 Nov 15;99(22):1883-1887. doi: 10.2106/JBJS.17.00414.
Concurrent and overlapping surgical procedures are a timely topic. The 2 largest publications on the topic were limited to a journalistic overview and a government committee report. Since then, a recent survey of paid individuals found that they disapprove of overlapping surgical procedures in many cases. Still, we are aware of no work that specifically polled patients and their family members about their beliefs on concurrent and overlapping surgical procedures. We hypothesized that patients and family members will be uncomfortable with 1 surgeon performing overlapping or concurrent surgical procedures.
A survey about concurrent and overlapping surgical procedures was given to 200 patients and their family members at a single, urban academic medical center. Participants were asked to respond to questions about their knowledge of concurrent and overlapping surgical procedures, their comfort with different surgical scenarios, and their beliefs on possible reasons for such surgical scenarios. Individuals were approached about the survey until 200 patients and family members responded.
On average, respondents were neutral with surgical procedures involving overlap of 2 noncritical portions and were not comfortable with overlap involving a critical portion of 1 or both surgical procedures. They agreed that hospitals allow overlapping surgical procedures to increase revenue.
Patients undergoing a surgical procedure at an academic medical center and their family members were neutral or uncomfortable with concurrent or overlapping surgical procedures, affirming the hypothesis. Knowing these preferences is relevant to surgeons' practices and to informed consent discussions. It appears beneficial for surgeons to address the advantages and disadvantages of overlapping surgical procedures with their patients if applicable.
同期和重叠手术是一个热门话题。关于该话题的两篇最大规模的出版物仅限于新闻综述和政府委员会报告。从那时起，最近一项针对有偿个体的调查发现，他们在许多情况下不赞成重叠手术。尽管如此，我们并未发现有专门针对患者及其家属对同期和重叠手术的看法进行调查的研究。我们假设患者及其家属会对一名外科医生进行重叠或同期手术感到不安。
在一家城市学术医疗中心，对200名患者及其家属进行了一项关于同期和重叠手术的调查。参与者被要求回答有关他们对同期和重叠手术的了解、对不同手术场景的接受程度以及对这些手术场景可能原因的看法等问题。持续邀请个人参与调查，直到获得200名患者及其家属的回复。
平均而言，受访者对涉及两个非关键部分重叠的手术持中立态度，而对涉及一个或两个手术关键部分重叠的手术感到不安。他们认为医院允许重叠手术是为了增加收入。
在学术医疗中心接受手术的患者及其家属对同期或重叠手术持中立或不安态度，证实了该假设。了解这些偏好与外科医生的实践以及知情同意讨论相关。如果适用，外科医生向患者说明重叠手术的优缺点似乎是有益的。
