Stucky Chee-Chee H, Cromwell Kate D, Voss Rachel K, Chiang Yi-Ju, Woodman Karin, Lee Jeffrey E, Cormier Janice N
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1484, Houston, TX 77030 USA.
Department of Neuro-oncology, The University of Texas MD Anderson Cancer Center, 1400 Holcombe Blvd, Unit 431, Houston, TX 77030 USA.
Ann Med Surg (Lond). 2018 Jan 9;27:1-8. doi: 10.1016/j.amsu.2017.12.013. eCollection 2018 Mar.
Many surgeons experience work-related pain and musculoskeletal symptoms; however, comprehensive reporting of surgeon ailments is lacking in the literature. We sought to evaluate surgeons' work-related symptoms, possible causes of these symptoms, and to report outcomes associated with those symptoms.
Five major medical indices were queried for articles published between 1980 and 2014. Included articles evaluated musculoskeletal symptoms and ergonomic outcomes in surgeons. A meta-analysis using a fixed-effect model was used to report pooled results.
Forty articles with 5152 surveyed surgeons were included. Sixty-eight percent of surgeons surveyed reported generalized pain. Site-specific pain included pain in the back (50%), neck (48%), and arm or shoulder (43%). Fatigue was reported by 71% of surgeons, numbness by 37%, and stiffness by 45%. Compared with surgeons performing open surgery, surgeons performing minimally invasive surgery (MIS) were significantly more likely to experience pain in the neck (OR 2.77 [95% CI 1.30-5.93]), arm or shoulder (OR 4.59 [2.19-9.61]), hands (OR 2.99 [1.33-6.71], and legs (OR 12.34 [5.43-28.06]) and experience higher odds of fatigue (8.09 [5.60-11.70]) and numbness (6.82 [1.75-26.65]). Operating exacerbated pain in 61% of surgeons, but only 29% sought treatment for their symptoms. We found no direct association between muscles strained and symptoms.
Most surgeons report work-related symptoms but are unlikely to seek medical attention. MIS surgeons are significantly more likely to experience musculoskeletal symptoms than surgeons performing open surgery. Symptoms experienced do not necessarily correlate with strain.
许多外科医生经历与工作相关的疼痛和肌肉骨骼症状；然而，文献中缺乏对外科医生疾病的全面报道。我们试图评估外科医生与工作相关的症状、这些症状的可能原因，并报告与这些症状相关的结果。
查询了1980年至2014年间发表的文章的五个主要医学索引。纳入的文章评估了外科医生的肌肉骨骼症状和人体工程学结果。使用固定效应模型进行荟萃分析以报告汇总结果。
纳入了40篇文章，共调查了5152名外科医生。68%接受调查的外科医生报告有全身性疼痛。特定部位的疼痛包括背部疼痛（50%）、颈部疼痛（48%）以及手臂或肩部疼痛（43%）。71%的外科医生报告有疲劳感，37%报告有麻木感，45%报告有僵硬感。与进行开放手术的外科医生相比，进行微创手术（MIS）的外科医生在颈部（比值比[OR]2.77[95%置信区间（CI）1.30 - 5.93]）、手臂或肩部（OR 4.59[2.19 - 9.61]）、手部（OR 2.99[1.33 - 6.71]）和腿部（OR 12.34[5.43 - 28.06]）出现疼痛的可能性显著更高，并且出现疲劳（8.09[5.60 - 11.70]）和麻木（6.82[1.75 - 26.65]）的几率更高。61%的外科医生手术会加剧疼痛，但只有29%的人因症状寻求治疗。我们发现肌肉拉伤与症状之间没有直接关联。
大多数外科医生报告有与工作相关的症状，但不太可能寻求医疗帮助。与进行开放手术的外科医生相比，进行微创手术的外科医生出现肌肉骨骼症状的可能性显著更高。所经历的症状不一定与拉伤相关。
