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外科住院医师的睡眠剥夺:它会影响腹腔镜肠吻合术的操作表现吗?

Sleep deprivation among surgical residents: Does it affect performance while practising a laparoscopic intestinal anastomosis?

机构信息

Servicio de Cirugía General, Hopistal de Jarrio, Coaña, Asturias, Spain.

Servicio de Cirugía General, Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Spain; Hospital virtual Valdecilla, Santander, Cantabria, Spain.

出版信息

Cir Esp (Engl Ed). 2022 Apr;100(4):223-228. doi: 10.1016/j.cireng.2022.03.014. Epub 2022 Apr 14.

Abstract

INTRODUCTION

To assess the impact of fatigue due to incorrect night rest in the performance of a laparoscopic manual anastomosis.

METHODS

A prospective study evaluating the results from the realization of a manual endotrainer entero-enteral anastomosis performed by residents in terms of fatigue caused by inadequate nightly rest. Two groups were established; the FATIGUE group (F): anastomosis performed by residents coming off shift who slept less than seven hours and the REST group(R), being those who slept at home for more than 7 h. The time taken, length of the anastomosis and quality of such were compared based on 4 parameters: Air leak test, correct tension on the suture line, accurate opposition of the edges and optimal distance between stitches.

RESULTS

402 anastomoses were studied (211 rest group, 191 fatigue group). In the fatigue group leaks were detected in 33.5% anastomoses, as opposed to 19.4% in the rest group (P < .01). El rest group performed the anastomosis in 56.75 min and the fatigue group in 61,49 min (P = .006). There were no significant differences in the others parameters.

CONCLUSIONS

Fatigue increases the risk of leakage and the time to do the exercise.

摘要

简介

评估因夜间休息不正确而导致的疲劳对腹腔镜手动吻合术表现的影响。

方法

一项前瞻性研究评估了由于夜间休息不足导致的疲劳对住院医师进行手动肠内吻合术的结果。建立了两组;疲劳组(F):下夜班的住院医师进行吻合术,睡眠时间少于 7 小时,休息组(R):在家睡眠时间超过 7 小时。根据 4 个参数比较吻合术的时间、吻合术的长度和吻合术的质量:气漏试验、缝线张力正确、边缘准确对合和缝线之间的最佳距离。

结果

共研究了 402 例吻合术(休息组 211 例,疲劳组 191 例)。在疲劳组中,33.5%的吻合术发现渗漏,而在休息组中为 19.4%(P<0.01)。休息组完成吻合术的时间为 56.75 分钟,疲劳组为 61.49 分钟(P=0.006)。其他参数无显著差异。

结论

疲劳增加了渗漏和手术时间的风险。

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