de Oliveira Tiago Ribeiro, Cleynenbreugel Ben Van, Pereira Sérgio, Oliveira Pedro, Gaspar Sandro, Domingues Nuno, Leitão Tito, Palmas Artur, Lopes Tomé, Poppel Hein Van
Department of Urology, Santa Maria University Hospital, Lisbon, Portugal.
Department of Urology, Armed Forces Hospital, Lisbon, Portugal.
Curr Urol. 2019 May 10;12(3):121-126. doi: 10.1159/000489437.
BACKGROUND/AIMS: Laparoscopy is a widespread surgical approach for many urological conditions. Achieving prof-ciency in laparoscopic surgery requires considerable effort due to the steep learning curve. Several residency programs include standardized laparoscopic training periods in their curricula. Our aim was to systematically analyze the evidence on the current status of training in laparoscopy in different residency programs in urology.
We performed a systematic review of PubMed/Medline and the Cochrane library, in February 2018, according to the Preferred Reporting Items for the Systematic Review and Meta-Analyses Statement. Identified reports were reviewed according to the previously defined inclusion criteria. Eight publications, comprising a total of 985 urology residents, were selected for inclusion in this analysis.
There was a wide variation between training programs in terms of exposure to laparoscopy. Most residents considered that training in lap-aroscopy was inadequate during residency and had a low degree of confidence in independently performing laparo-scopic procedures by the end of the residency. Only North American residents reported high degrees of confidence in the possibility of performing laparoscopic procedures in the uture, whereas the remaining residents, namely from European countries, reported considerably lower degrees of confidence.
There were considerable differences between national urology residency programs in terms of exposure to laparoscopy. Most residents would prefer higher exposure to laparoscopy throughout their residencies.
背景/目的：腹腔镜检查是治疗多种泌尿外科疾病广泛采用的手术方法。由于学习曲线陡峭，要熟练掌握腹腔镜手术需要付出巨大努力。一些住院医师培训项目在其课程中纳入了标准化的腹腔镜培训阶段。我们的目的是系统分析不同泌尿外科住院医师培训项目中腹腔镜培训现状的相关证据。
根据系统评价和Meta分析的首选报告项目声明，我们于2018年2月对PubMed/Medline和Cochrane图书馆进行了系统评价。根据先前定义的纳入标准对检索到的报告进行审查。选择了8篇出版物，共涉及985名泌尿外科住院医师纳入本分析。
各培训项目在腹腔镜检查的接触机会方面存在很大差异。大多数住院医师认为住院期间腹腔镜检查培训不足，到住院医师培训结束时，他们对独立进行腹腔镜手术的信心较低。只有北美住院医师对未来进行腹腔镜手术的可能性报告有高度信心，而其余来自欧洲国家的住院医师报告的信心程度则低得多。
各国泌尿外科住院医师培训项目在腹腔镜检查的接触机会方面存在显著差异。大多数住院医师希望在整个住院医师培训期间有更多机会接触腹腔镜检查。
