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综合普通外科肿瘤学住院医师培训项目的住院医师对直肠癌盆腔 MRI 缺乏信心:需求评估调查结果。

Residents entering Complex General Surgical Oncology fellowship lack confidence with pelvic MRI for rectal cancer: Results of a needs assessment survey.

机构信息

Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Am J Surg. 2020 Feb;219(2):304-308. doi: 10.1016/j.amjsurg.2019.11.012. Epub 2019 Nov 11.

Abstract

BACKGROUND

Magnetic resonance imaging (MRI) is essential for the multidisciplinary treatment of rectal cancer. However, baseline experience of surgical residents with MRI is unknown. Therefore, a needs assessment survey was conducted to examine confidence with pelvic MRI for residents entering Complex General Surgical Oncology (CSGO) fellowships.

METHODS

A multi-institutional survey evaluated incoming CGSO fellows' experience with pelvic MRI for rectal cancer in residency. Additionally, confidence was assessed for essential components of pelvic MRI including T- and N-stage, circumferential resection margin (CRM), extramural venous invasion (EMVI), and pelvic anatomy.

RESULTS

Of the twenty-four incoming fellows who completed the survey (response rate = 44%), 20 reported frequent use of pelvic MRI for rectal cancer in residency, but 16 reported rarely/never interpreting images themselves for staging or operative planning. Most respondents reported low confidence for T-stage, N-stage, CRM, EMVI, as well as pelvic anatomy, particularly for lateral and posterior pelvis.

CONCLUSIONS

The development of a pelvic MRI curriculum for residents entering CGSO fellowships could enhance their clinical training in the multidisciplinary management of patients with rectal cancer.

摘要

背景

磁共振成像(MRI)对于直肠癌的多学科治疗至关重要。然而,外科住院医师对 MRI 的基础经验尚不清楚。因此,进行了一项需求评估调查,以检查即将进入复杂普通外科肿瘤学(CSGO)奖学金的住院医师对 MRI 检查骨盆的信心。

方法

一项多机构调查评估了即将进入 CSGO 的住院医师在 residency 期间对 MRI 检查骨盆直肠癌的经验。此外,还评估了对包括 T 期和 N 期、环周切缘(CRM)、外膜静脉侵犯(EMVI)和骨盆解剖在内的 MRI 检查骨盆的基本组成部分的信心。

结果

在完成调查的二十四名即将进入的住院医师中(应答率为 44%),有 20 名报告在 residency 期间经常使用 MRI 检查骨盆直肠癌,但有 16 名报告很少/从未自己解释过图像以进行分期或手术计划。大多数受访者对 T 期、N 期、CRM、EMVI 以及骨盆解剖结构,尤其是骨盆的侧面和后部,报告的信心较低。

结论

为进入 CSGO 奖学金的住院医师制定骨盆 MRI 课程可以增强他们在直肠癌多学科管理方面的临床培训。

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