Department of Surgery, Methodist Richardson Medical Center, Richardson, Texas.
Department of Surgery, Methodist Richardson Medical Center, Richardson, Texas; Department of Surgery, Albany Medical College, New York, New York.
J Surg Educ. 2021 Sep-Oct;78(5):1593-1598. doi: 10.1016/j.jsurg.2021.01.012. Epub 2021 Jan 28.
The goal of the 1-year Advanced Gastrointestinal (AGI) surgery fellowship is to train the general surgeon to perform advanced and complex operations that they had insufficient experience with in residency training. This study examines the case logs of AGI fellows that have completed Society for Surgery of the Alimentary Tract (SSAT)-sponsored Fellowship Council (FC)-accredited AGI fellowships to determine the role of these fellowships in providing complex gastrointestinal operative experience.
DESIGN/PARTICIPANTS: Institutional Review Board-approved retrospective surgical case log analysis. Case logs of 60 AGI fellows in 12 different AGI fellowships from 2014 to 2019 were requested by the SSAT and provided in a de-identified format from the FC. Cases were categorized as colorectal surgery, anus, hernia-abdomen, hernia inguinal, esophagus-hiatal hernia, esophagus-Heller, pancreas, liver, bile duct, diagnostic/therapeutic esophagogastroduodenoscopy (EGD), diagnostic/therapeutic colonoscopy, thoracic esophagus, thoracic lung, spleen, thyroid, diaphragm, gastric, abdomen, adrenal/kidney, bariatric, diagnostic/therapeutic bronchoscopy, kidney/liver/pancreas transplant, and trauma.
AGI fellows performed a mean of 345 cases per year (range: 184-558). Our results showed that 5 programs provided >30 colorectal cases, 6 provided >50 hernia (hernia-abdomen and hernia-inguinal) cases, 8 provided >25 hiatal hernia cases, 2 provided >100 endoscopy cases (diagnostic/therapeutic EGD and diagnostic/therapeutic colonoscopy), 6 provided >30 gastric cases, 3 provided >100 bariatric cases, 6 provided >10 pancreas cases, 3 provided >10 liver cases, and 4 provided >6 biliary cases.
SSAT-sponsored FC-accredited AGI fellowship programs provide a wide array of training in complex gastrointestinal surgeries. Most programs provide broad training in hiatal work, colorectal surgery, hepato-pancreato-biliary surgery, and abdominal wall reconstruction. This FC-accredited AGI training paradigm prepares trainees for broad-based complex abdominal surgery, an area that is sorely needed to augment insufficient experience in many general surgical training programs.
为期一年的高级胃肠（AGI）手术研究员的目标是培训普通外科医生，使其能够进行 residency 培训中经验不足的高级和复杂手术。本研究通过对已完成由外科医师学会消化道外科分会（SSAT）赞助的研究员理事会（FC）认可的 AGI 研究员 fellowship 计划的 60 名 AGI 研究员的案例记录进行分析，以确定这些研究员计划在提供复杂胃肠手术经验方面的作用。
设计/参与者：机构审查委员会批准的回顾性手术案例记录分析。从 FC 以匿名格式请求 SSAT 并提供 2014 年至 2019 年的 12 个不同的 AGI 研究员 fellowship的 60 名 AGI 研究员的案例记录。病例分为结肠直肠手术、肛门、疝-腹部、腹股沟疝、食管-裂孔疝、食管-Heller、胰腺、肝脏、胆管、诊断/治疗性食管胃十二指肠镜检查（EGD）、诊断/治疗性结肠镜检查、胸食管、胸肺、脾、甲状腺、膈、胃、腹部、肾上腺/肾脏、减肥、诊断/治疗性支气管镜检查、肾脏/肝脏/胰腺移植和创伤。
AGI 研究员每年平均完成 345 例手术（范围：184-558）。我们的结果表明，有 5 个项目提供了>30 例结肠直肠手术，6 个项目提供了>50 例疝（疝-腹部和疝-腹股沟）手术，8 个项目提供了>25 例裂孔疝手术，2 个项目提供了>100 例内镜手术（诊断/治疗性 EGD 和诊断/治疗性结肠镜检查），6 个项目提供了>30 例胃手术，3 个项目提供了>100 例减肥手术，6 个项目提供了>10 例胰腺手术，3 个项目提供了>10 例肝脏手术，4 个项目提供了>6 例胆道手术。
SSAT 赞助的 FC 认可的 AGI 研究员 fellowship 计划提供了广泛的复杂胃肠手术培训。大多数项目提供广泛的膈疝、结肠直肠手术、肝胰胆手术和腹壁重建培训。这种经过 FC 认可的 AGI 培训模式为培训人员提供了广泛的复杂腹部手术基础，这在许多普通外科培训项目中经验不足的情况下是非常需要的。
