Department of General Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, 33006, China.
Department of Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
BMC Surg. 2021 Jan 22;21(1):54. doi: 10.1186/s12893-021-01062-0.
Surgeons are likely to get progressively fatigued during the course of a normal workday. The objective of this study was to evaluate the impact of surgeon work duration prior to performing distal pancreatectomy (DP) on the perioperative outcome, especially frequency of grade II or higher grade postoperative complications.
Patients undergoing DP for all causes were divided into two groups according to surgeon work hours prior to performing DP: group A (less than 5 h) and group B (5-10 h). Propensity score matching (PSM) analysis (1:1) were performed to balance the baseline characteristics between the two groups. Intraoperative complications were compared between the two groups. Postoperative complications and their severity were followed up for 60 days and mortality for 90 days. The study was powdered to identify a 15% difference in the incidence of grade II or higher grade complications.
By using PSM analysis, the patients in group A (N = 202) and group B (N = 202) were well matched regarding demographics, comorbidities, operative technique, pancreatic texture and pathology. There was no significant difference in the incidence of grade II or higher grade complications between the two groups. There was no difference in clinically relevant postoperative pancreatic fistula, percutaneous drainage, readmission, reoperation, or morality. Group B was associated with a higher incidence of intraoperative organ injury, which could be managed successfully during the operation.
The retrospective study demonstrated that the surgeon work duration did not significantly affect the clinical outcome of DP.
外科医生在正常工作日期间可能会逐渐疲劳。本研究的目的是评估在进行远端胰腺切除术 (DP) 之前外科医生的工作时间对围手术期结果的影响，特别是术后 II 级或更高等级并发症的频率。
根据外科医生在进行 DP 之前的工作时间，将因各种原因接受 DP 的患者分为两组：A 组（少于 5 小时）和 B 组（5-10 小时）。进行倾向评分匹配 (PSM) 分析 (1:1) 以平衡两组之间的基线特征。比较两组之间的术中并发症。术后并发症及其严重程度随访 60 天，死亡率随访 90 天。该研究旨在确定 II 级或更高等级并发症发生率差异 15%。
通过使用 PSM 分析，A 组（N=202）和 B 组（N=202）在人口统计学、合并症、手术技术、胰腺质地和病理方面具有良好的匹配。两组之间 II 级或更高等级并发症的发生率无显着差异。两组在临床上相关的胰瘘、经皮引流、再入院、再次手术或死亡率方面无差异。B 组与术中器官损伤的发生率较高相关，但可以在手术期间成功处理。
回顾性研究表明，外科医生的工作时间不会显著影响 DP 的临床结果。
