Loyola University Chicago, Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153, Ph: +1 213-268-3030.
Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, Ph: +1 949-521-3086.
Spine J. 2021 Jun;21(6):889-898. doi: 10.1016/j.spinee.2021.03.001. Epub 2021 Mar 3.
Recent media coverage of overlapping surgery has led to several studies investigating public perception of concurrent and overlapping surgery, both of which involve a single attending surgeon working on two separate cases in two separate operating rooms. In concurrent surgery, the critical periods of the surgeries overlap, while in overlapping surgery they do not. The literature revealed a general lack of knowledge about these practices and strong disapproval of their use by the public.
To determine the comfort level of spine surgery patients and their family members toward concurrent and overlapping surgery.
STUDY DESIGN/SETTING: This cross-sectional survey study was performed at an urban, adult academic spine surgery clinic.
Patients and their companions who were waiting to be seen at their initial clinic visit or follow-up visit were approached to participate in the study.
The survey queried respondents' baseline knowledge of and comfort level with concurrent and overlapping surgery, in addition to comfort level with different levels of surgical trainees on a 5-point Likert scale.
A five-section, 36-item questionnaire was administered by a research assistant to respondents over a 3-month period spanning June 2019 - August 2019. A research assistant described the terms overlapping surgery and concurrent surgery to participants of the survey using diagrams and a preformulated script after self-reported knowledge questions. Statistical analysis was performed using the chi-square test for categorical variables, and Kendall's tau-c rank correlation coefficient with ordinal independent variables for correlations.
Knowledge about concurrent and overlapping surgery was low in our study population (8.22% and 6.16%, respectively). Over half of respondents reported that they felt comfortable with overlapping surgery (58.22%). Most respondents reported that they would like their surgeon to disclose the participation of surgical trainees (residents and fellows) in their surgery (98%). In addition, the 4th and 5th years of surgical training were associated with a significant increase in patient comfort with surgical trainee participation. There was no difference in response distribution between patients versus nonpatients.
Knowledge about concurrent and overlapping surgery remains poor in our study population. Lack of general knowledge about overlapping surgery can be a serious impediment to obtaining informed consent, and further study is required to determine the best methods to raising patient awareness.
最近媒体对重叠手术的报道导致了几项研究调查公众对同时和重叠手术的看法，这两种手术都涉及一名主治医生在两个不同的手术室中同时为两个独立的病例进行手术。在同时手术中，手术的关键时期重叠，而在重叠手术中则不重叠。文献表明，公众对这些手术缺乏普遍的了解，并强烈反对使用这些手术。
确定脊柱外科患者及其家属对同时和重叠手术的舒适度。
研究设计/地点：这是一项在城市成人脊柱外科诊所进行的横断面调查研究。
在初次就诊或随访就诊时正在等待就诊的患者及其陪同人员被邀请参加研究。
调查询问了受访者对同时和重叠手术的基本了解和舒适度，以及对不同水平的外科受训人员的舒适度，采用 5 分李克特量表进行评估。
在 2019 年 6 月至 2019 年 8 月的 3 个月期间，由一名研究助理向受访者发放了五部分共 36 个问题的问卷。在调查参与者的问题中，研究助理使用图表和预先制定的脚本，向参与者描述了重叠手术和同时手术的术语。使用卡方检验进行分类变量的统计分析，使用肯德尔 tau-c 秩相关系数进行有序自变量的相关性分析。
我们的研究人群对同时和重叠手术的了解程度较低（分别为 8.22%和 6.16%）。超过一半的受访者表示他们对重叠手术感到舒适（58.22%）。大多数受访者表示希望他们的外科医生在手术中披露外科受训人员（住院医生和研究员）的参与情况（98%）。此外，第 4 年和第 5 年的外科培训与患者对受训人员参与手术的舒适度显著增加有关。患者和非患者的反应分布没有差异。
我们的研究人群对同时和重叠手术的了解仍然很差。公众对重叠手术缺乏普遍的了解，可能会严重阻碍获得知情同意，因此需要进一步研究确定提高患者意识的最佳方法。
