ICENI Centre, Colchester, UK.
Colorectal Dis. 2018 Jun;20(6):496-501. doi: 10.1111/codi.14034.
The aim was to document the outcomes of surgeons attending a cadaveric simulation course designed to provide an introduction to transanal total mesorectal excision (TaTME).
This was a prospective observational study documenting the outcomes from classroom and wet lab activities. Follow-up questionnaires were used to monitor clinical activity after the course.
Outcomes of 65 delegates from 12 different countries attending seven cadaveric simulation courses are described. Median time to insert and close the rectal purse-string was 15 min (range 7-50 min) and median time to complete the transanal mesorectal dissection was 105 min (range 60-260 min). Objective assessment of specimen quality showed that 42% of specimens were complete, 47% nearly complete and 11% were incomplete. Failure of the intraluminal rectal purse-string was the most common difficulty encountered. Within 6 months of attending the course, nearly half (26/55; 47%) of the surgeons who responded had performed between 1 and 13 TaTMEs. Only 8/26 (31%) of the surgeons had arranged mentoring for their first case.
This training model provides high levels of trainee satisfaction and the knowledge and technical skills to enable them to start performing TaTME. There is still work to do to provide adequate supervision and mentorship for surgeons early on their learning curve that is essential for the safe introduction of this new technique.
记录参加旨在介绍经肛门全直肠系膜切除术（TaTME）的尸体模拟课程的外科医生的结果。
这是一项前瞻性观察研究，记录了课堂和湿实验室活动的结果。使用随访问卷来监测课程结束后的临床活动。
描述了来自 12 个不同国家的 65 名代表参加了 7 次尸体模拟课程的结果。插入和关闭直肠荷包缝线的中位时间为 15 分钟（范围为 7-50 分钟），完成经肛门中直肠系膜解剖的中位时间为 105 分钟（范围为 60-260 分钟）。标本质量的客观评估显示，42%的标本完整，47%的标本接近完整，11%的标本不完整。腔内直肠荷包缝线失败是最常见的困难。在参加课程后的 6 个月内，近一半（26/55；47%）的有回应的外科医生已经完成了 1 至 13 例 TaTME。只有 8/26（31%）的外科医生为他们的第一例手术安排了指导。
这种培训模式提供了高水平的学员满意度以及知识和技术技能，使他们能够开始进行 TaTME。仍然需要为早期学习曲线的外科医生提供足够的监督和指导，这对于安全引入这项新技术至关重要。
