现场手术：7 例骨科现场手术事件的结果和并发症的回顾性研究。
Live Surgery: A retrospective study on the outcomes and complications of 7 orthopedic live surgery events.
机构信息
Alps surgery institute: hand, upper limb, brachial plexus, and microsurgery unit (PBMA), clinique générale d'Annecy, 4, chemin de la Tour la Reine, 74000 Annecy, France.
Department of orthopedics and traumatology-service of hand and upper limb, Saint Antoine hospital, Assistance Publique-hôpitaux de Paris (AP-HP), 184, rue du faubourg Saint Antoine, 75012, Paris, France.
出版信息
Orthop Traumatol Surg Res. 2021 Dec;107(8):102871. doi: 10.1016/j.otsr.2021.102871. Epub 2021 Feb 24.
INTRODUCTION
Live surgery has always been an invaluable part of medical education. Live Surgery Events (LSE) have recently been criticized in France, arguing that unnecessary risks have been placed on the patients.
HYPOTHESIS
We want to report our experience in organizing the last 7 shoulder LSE over the past 12 years focusing on the results and complications during and after the surgeries performed during these courses.
MATERIAL AND METHODS
190 patients benefited from live shoulder surgery between 2005 and 2017. 11 of them were lost to follow up, thus 179 patients were included. The mean follow-up was 7,5 years for the instability group, 6,7 years for the rotator cuff group, 7,5 years for the arthroplasty group and 6,8 years for the nerve group. This study is a retrospective analysis of prospectively collected data. We report the epidemiology of the surgeries perfomed and analyzed the patient outcomes: peri and postoperative complications. We evaluated the educational benefit for the attendees of this shoulder LSE through a questionnaire.
RESULTS
There were 6 (3.1%) peri or immediate postoperative complications. There were 33 (18%) long term complications needing 26 (14%) revisions. 90% of the surgeons audience attending the events evaluated the educational benefit from good to very good.
DISCUSSION
Over the years, we have standardized the organization of the meeting to ensure maximum safety, while still respecting patient integrity and anonymity. Our complications rates seem within the ranges found in the current literature for each procedure. Our LSE has been an instrument for education, but also for matching patients with complex problems with experienced surgeons, to the benefit of the patient. Our experience has shown that LSE may induce potential dangers and complications can arise. However, these events should follow rigorous rules and not just recommendations.
LEVEL OF EVIDENCE
IV; retrospective analysis of prospectively collected data.
简介
现场手术一直是医学教育中非常宝贵的一部分。最近，法国对现场手术活动（LSE）提出了批评，认为这给患者带来了不必要的风险。
假设
我们想报告过去 12 年来组织最后 7 次肩部 LSE 的经验，重点介绍这些课程中进行的手术期间和之后的结果和并发症。
材料和方法
2005 年至 2017 年间，有 190 名患者受益于肩部现场手术。其中 11 人失访，因此共纳入 179 名患者。不稳定组的平均随访时间为 7.5 年，肩袖组为 6.7 年，关节置换组为 7.5 年，神经组为 6.8 年。本研究是对前瞻性收集数据的回顾性分析。我们报告了手术的流行病学，并分析了患者的结果：围手术期和术后并发症。我们通过问卷调查评估了参加该肩部 LSE 的医生的教育收益。
结果
有 6 例（3.1%）围手术期或术后即刻并发症。有 33 例（18%）长期并发症需要 26 例（14%）翻修。90%的参加该活动的外科医生认为教育收益良好到非常好。
讨论
多年来，我们已经将会议的组织标准化，以确保最大程度的安全，同时仍然尊重患者的完整性和匿名性。我们的并发症发生率似乎在每种手术的当前文献范围内。我们的 LSE 一直是教育的工具，但也为将有复杂问题的患者与经验丰富的外科医生匹配，以造福患者。我们的经验表明，LSE 可能会带来潜在的危险，并且可能会出现并发症。然而，这些事件应该遵循严格的规则，而不仅仅是建议。
证据等级
IV；前瞻性收集数据的回顾性分析。
Zotero 插件