Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey.
Department of Surgery, New York University Langone Health, New York, NY, USA.
Langenbecks Arch Surg. 2020 Feb;405(1):63-69. doi: 10.1007/s00423-020-01858-3. Epub 2020 Jan 31.
Live surgical demonstrations are considered an effective educational tool providing a chance for trainees to observe a real-time decision-making process of expert surgeons. No data exists evaluating the impact of live surgical demonstrations on the outcomes of minimally invasive colorectal surgery. This study evaluates perioperative and short-term postoperative outcomes in patients undergoing minimally invasive colorectal surgery in the setting of live surgical demonstrations.
Patients undergoing minimally invasive colorectal surgery which was performed as live surgical demonstrations (the study group) performed between 2006 and 2018 were reviewed. These patients were case-matched with those undergoing operations in routine practice (the control group). The study and control group were compared for intraoperative and short-term postoperative outcomes.
Thirty-nine live surgery cases in the study group were case-matched with its thirty-nine counterparts as the control group. Operating time was longer (200 vs 165 min; p = 0.002) and estimated intraoperative blood loss was higher in the study group (100 vs 55 ml; p = 0.008). Patients in the study group stayed longer in the hospital (6 vs 5 days; p = 0.001). While conversion (n = 4 vs n = 1, p = 0.358) and intraoperative complications (n = 6 vs n = 2, p = 0.2) were more frequent in the study group, these outcomes did not reach statistical significance. Overall complications were higher in the study group (n = 22 vs n = 9, p = 0.003). One patient underwent a reoperation due to postoperative bleeding, and one mortality occurred in the live surgery group.
Live surgical demonstrations in minimally invasive colorectal surgery seem to be associated with increased risk of operative morbidity.
现场手术演示被认为是一种有效的教育工具，为学员提供了观察专家外科医生实时决策过程的机会。目前尚无数据评估现场手术演示对微创结直肠手术结果的影响。本研究评估了在现场手术演示环境下接受微创结直肠手术患者的围手术期和短期术后结果。
回顾了 2006 年至 2018 年期间进行的微创结直肠手术（研究组）作为现场手术演示的患者。这些患者与在常规实践中接受手术的患者（对照组）进行了病例匹配。研究组和对照组的术中及短期术后结果进行了比较。
研究组的 39 例现场手术与对照组的 39 例手术相匹配。研究组的手术时间较长（200 分钟 vs 165 分钟；p=0.002），术中估计出血量较高（100 毫升 vs 55 毫升；p=0.008）。研究组患者在医院的停留时间较长（6 天 vs 5 天；p=0.001）。虽然研究组的中转率（n=4 例 vs n=1 例，p=0.358）和术中并发症发生率（n=6 例 vs n=2 例，p=0.2）较高，但这些结果没有统计学意义。研究组的总体并发症发生率较高（n=22 例 vs n=9 例，p=0.003）。1 例患者因术后出血行再次手术，1 例死亡发生在现场手术组。
微创结直肠手术中的现场手术演示似乎与手术发病率增加有关。
