Zaubitzer Lena, Affolter Annette, Büttner Sylvia, Ludwig Sonja, Rotter Nicole, Scherl Claudia, von Wihl Sonia, Weiß Christel, Lammert Anne
Klinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Halschirurgie, Universitätsklinikum Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Medizinische Statistik, Biomathematik und Informationsverarbeitung, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland.
HNO. 2022 Jun;70(6):436-444. doi: 10.1007/s00106-021-01119-9. Epub 2021 Nov 14.
Accurate planning of operating times in surgical clinics is essential. Moreover, high-capacity utilization of operating rooms (ORs) is necessary for economic efficiency.
Most planning of operating times is performed by surgeons. Herein, surgeons' estimated times and the objective times for performing surgical procedures were compared to detect sources of error.
In a retrospective analysis, the durations of 1809 operations using general anesthesia (22 types of surgery) by 31 surgeons (12 specialists and 19 residents) were compared. Comparisons were analyzed by Mann-Whitney U‑tests.
The comparison of objective times of surgical action showed significant differences between specialists and residents in 6 of 15 types of surgeries. The post-processing times estimated by specialists deviated from the objective times in 2 out of 22 surgery types, while the post-processing times estimated by residents deviated in 7 of 15 types. Specialists misjudged the incision-to-suture times in 7 of 22 surgery types, and residents misjudged these times in 3 of 15 types. The preparation times estimated by specialists deviated from the objective times in 16 of 22 types of surgeries and in 7 of 15 types estimated by residents.
A surgeon's routine must be carefully considered in order to estimate operating times. Specialists generally underestimated preparation and post-processing times and overestimated incision-to-suture times, whereas residents underestimated all three. Preparation and post-processing times must be considered in planning and, ideally, determined together with anesthesiologists and surgical assistants.
准确规划外科诊所的手术时间至关重要。此外，为提高经济效益，手术室的高容量利用也很有必要。
大多数手术时间的规划由外科医生完成。在此，比较外科医生的预估时间与手术操作的实际时间，以找出误差来源。
在一项回顾性分析中，比较了31位外科医生（12位专科医生和19位住院医生）进行的1809例全身麻醉手术（22种手术类型）的时长。采用曼-惠特尼U检验进行比较分析。
在15种手术类型中的6种，专科医生和住院医生的手术实际时间存在显著差异。专科医生预估的术后处理时间在22种手术类型中的2种与实际时间有偏差，而住院医生预估的术后处理时间在15种手术类型中的7种与实际时间有偏差。专科医生在22种手术类型中的7种误判了切开至缝合时间，住院医生在15种手术类型中的3种误判了这些时间。专科医生预估的准备时间在22种手术类型中的16种与实际时间有偏差，住院医生预估的准备时间在15种手术类型中的7种与实际时间有偏差。
为预估手术时间，必须仔细考虑外科医生的常规操作。专科医生通常低估准备和术后处理时间，高估切开至缝合时间，而住院医生则低估所有这三项时间。在规划中必须考虑准备和术后处理时间，理想情况下，应与麻醉医生和手术助手共同确定这些时间。
