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农村普通外科医生正在实施哪些手术,他们在实际操作中是否准备好实施专科手术?

What Procedures Are Rural General Surgeons Performing and Are They Prepared to Perform Specialty Procedures in Practice?

作者信息

Stiles Roxanne, Reyes Jared, Helmer Stephen D, Vincent Kyle B

出版信息

Am Surg. 2019 Jun 1;85(6):587-594.

Abstract

Rural surgeons are performing operations typically performed by "specialists." This study describes specialty procedures performed by general surgeons operating in a rural state and how prepared the surgeons felt starting their rural practice after residency A survey was sent to all exclusively rural surgeons actively practicing in the state, inquiring about their perception of preparedness for rural practice and specialty procedures performed. The survey had a 65.2 per cent response rate. Responders felt well prepared for rural practice after residency (mean response 4.6 ± 0.8 on a Likert scale from 1 to 5; 5 = "well prepared"). Noteworthy, specialty procedures performed by rural surgeons included hysterectomies (51.2%), thyroidectomies (81.4%), parathyroidectomies (60.5%), carotid endarterectomies (11.6%), video-assisted thoracoscopic surgery (37.2%), and lobectomies (23.3%). Prominent write-ins included nephrectomies (n = 1), ileal conduits (n = 1), open and endovascular abdominal aortic aneurysm repair (n = 1), Whipples (n = 3), and liver resections (n = 2). Rural general surgeons perform many major operations usually performed by specialists. These surgeons felt well prepared for these operations out of residency.

摘要

乡村外科医生正在开展通常由“专科医生”进行的手术。本研究描述了在一个乡村州执业的普通外科医生所开展的专科手术,以及这些外科医生在完成住院医师培训后开始乡村执业时的准备情况。向该州所有积极执业的纯乡村外科医生发送了一份调查问卷,询问他们对乡村执业准备情况以及所开展的专科手术的看法。该调查的回复率为65.2%。受访者认为在完成住院医师培训后对乡村执业准备充分(在1至5分的李克特量表上平均回复为4.6±0.8;5分表示“准备充分”)。值得注意的是,乡村外科医生所开展的专科手术包括子宫切除术(51.2%)、甲状腺切除术(81.4%)、甲状旁腺切除术(60.5%)、颈动脉内膜切除术(11.6%)、电视辅助胸腔镜手术(37.2%)和肺叶切除术(23.3%)。突出的自行填写内容包括肾切除术(n = 1)、回肠代膀胱术(n = 1)、开放和血管腔内腹主动脉瘤修复术(n = 1)、惠普尔手术(n = 3)和肝切除术(n = 2)。乡村普通外科医生开展许多通常由专科医生进行的大型手术。这些外科医生认为在完成住院医师培训后对这些手术准备充分。

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