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住院医师在主治医生监督下进行单孔腹腔镜阑尾切除术的可行性与安全性

Feasibility and Safety of Single-Incision Laparoscopic Appendectomy by a Surgical Resident under Supervision of a Staff Surgeon.

作者信息

Joo Jung Il, Park Jung Ho, Kim Dong Hyun, Lim Sang Woo

机构信息

Department of Surgery, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.

出版信息

J Minim Invasive Surg. 2019 Jun;22(2):55-60. doi: 10.7602/jmis.2019.22.2.55. Epub 2019 Jun 15.

Abstract

PURPOSE

This study was aimed at reporting our experience with single-incision laparoscopic appendectomies (SILA) performed by a surgical resident, and to evaluate the safety and feasibility of the procedure, together with a comparison of the outcomes of the same procedure performed by a staff surgeon.

METHODS

We conducted a retrospective case series analysis of 60 consecutive patients who underwent SILA. Two surgeons, an attending staff surgeon and a second-year surgical resident, performed the SILA procedures. SILA procedures performed by the resident were intraoperatively guided and supervised by the staff surgeon.

RESULTS

A total of 60 case-matched patients with acute appendicitis underwent a SILA performed by either the resident or attending staff. There was no difference in patient demographics between the two groups of patients. The mean operation time was longer in the resident group than in the staff group (43.2±6.0 minutes vs. 32.9±10.5 minutes, <0.001). There was no significant difference in the operative data between the two groups. No conversion to an open procedure occurred in either group. Postoperative pain, time to onset of oral intake, and number of days of postoperative hospital stay were similar in both groups.

CONCLUSION

SILA procedures performed by a resident are safe and feasible despite longer operation times. Perioperative supervision and guidance by an attending staff surgeon may facilitate surgical outcomes.

摘要

目的

本研究旨在报告外科住院医师进行单切口腹腔镜阑尾切除术(SILA)的经验,并评估该手术的安全性和可行性,同时比较由主治医师进行相同手术的结果。

方法

我们对连续60例行SILA的患者进行了回顾性病例系列分析。两名外科医生,一名主治医师和一名二年级外科住院医师,进行了SILA手术。住院医师进行的SILA手术在术中由主治医师指导和监督。

结果

共有60例急性阑尾炎患者进行了由住院医师或主治医师实施的SILA手术。两组患者的人口统计学特征无差异。住院医师组的平均手术时间比主治医师组长(43.2±6.0分钟对32.9±10.5分钟,<0.001)。两组之间的手术数据无显著差异。两组均未发生转为开放手术的情况。两组术后疼痛、开始经口进食时间和术后住院天数相似。

结论

住院医师进行的SILA手术尽管手术时间较长,但安全可行。主治医师在围手术期的监督和指导可能有助于手术结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a456/8980146/735b0e3c5672/jmis-22-2-055f1.jpg

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