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手术过程直播的安全性和有效性:系统评价。

Safety and effectiveness of live broadcast of surgical procedures: systematic review.

机构信息

Department of General Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, BA21 4AT, UK.

Department of Trauma and Orthopaedic Surgery, Yeovil District Hospital, Higher Kingston, Yeovil, BA21 4AT, UK.

出版信息

Surg Endosc. 2022 Aug;36(8):5571-5594. doi: 10.1007/s00464-022-09072-6. Epub 2022 May 23.

Abstract

INTRODUCTION

Live Broadcast of Surgical Procedures (LBSP) has gained popularity in conferences and educational meetings in the past few decades. This is due to rapid advancement in both Minimally Invasive Surgery (MIS) that enable transmission of the entire operative field and transmission ease and technology to help broadcast the operation to a live audience. The aim of this study was to update the evidence with specific emphasis on the patient safety issues related to LBSP in MIS.

METHODS

A systematic review of the literature was performed using Medline, Embase and Pubmed using defined search terms related to LBSP in educational events across all surgical specialities, in accordance with the PRISMA guidelines. We also consolidated the prior guidelines and position statements on this topic. Outcomes included reports on the educational value of LBSP as well as patient safety outcomes and ethical issues that were captured by clinical outcomes.

RESULTS

A total 1230 abstracts were identified with 27 papers meeting the inclusion criteria (13 original articles and 14 position statements/guidelines). All studies highlighted the educational benefits of LBSP but without clear measure of these benefits. Clinical outcomes were not compromised in 9 studies but were inferior in the remaining 4, including lower completion rate of endoscopic surgery and higher rate of re-operation. Only nine studies complied with dedicated consent forms for LBSP with no consistent approach of reporting on maintaining patient confidentiality during LBSP. There was a lack of recommendation on standardised approach of reporting on LBSP including the outcomes across the 14 published guidelines and positions statements.

CONCLUSIONS

Live Broadcast of Surgical Procedures can be of educational value but patient safety may be compromised. A standardised framework of reporting on LBSP and its outcomes is required from an ethical and patient safety perspective.

PROSPERO REGISTRATION

CRD42021256901.

摘要

引言

在过去几十年中,手术过程直播(LBSP)在会议和教育会议中越来越受欢迎。这是由于微创外科(MIS)的快速发展,使得整个手术领域的传输以及传输的便利性和技术得以实现,从而将手术直播到现场观众。本研究的目的是更新证据,特别强调与 MIS 中 LBSP 相关的患者安全问题。

方法

根据 PRISMA 指南,使用 Medline、Embase 和 Pubmed 对与所有外科专业教育活动中 LBSP 相关的文献进行了系统回顾,并使用了定义的搜索词。我们还整合了关于该主题的先前指南和立场声明。结果包括关于 LBSP 的教育价值以及通过临床结果捕获的患者安全结果和伦理问题的报告。

结果

共确定了 1230 篇摘要,其中 27 篇文章符合纳入标准(13 篇原始文章和 14 篇立场声明/指南)。所有研究都强调了 LBSP 的教育益处,但没有明确衡量这些益处。在 9 项研究中,临床结果没有受到影响,但在其余 4 项研究中,手术完成率较低,内镜手术的再手术率较高。只有 9 项研究符合 LBSP 的专用同意书要求,在 LBSP 期间维护患者保密性的报告方式没有一致的方法。在 14 份已发布的指南和立场声明中,缺乏关于报告 LBSP 及其结果的标准化方法的建议。

结论

手术过程直播具有教育价值,但患者安全可能受到影响。从伦理和患者安全的角度来看,需要有一个报告 LBSP 的标准化框架及其结果。

PROSPERO 注册号:CRD42021256901。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98ad/9125972/e493d13c86f1/464_2022_9072_Fig1_HTML.jpg

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