Department of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Updates Surg. 2023 Sep;75(6):1597-1605. doi: 10.1007/s13304-023-01540-5. Epub 2023 May 22.
Anal diseases are very common and, in most of the cases, require surgery of minor or medium complexity, and, therefore, are among the most accessible diseases for surgeons in training. Aim of this study is to investigate the status of the training in proctology in Italy. A 31-items questionnaire was administered to residents and young specialists (≤ 2 years) in general surgery, using mailing lists, and the social media accounts of the Italian Society of Colorectal Surgery. Answers from 338 respondents (53.8% males) were included in the final analysis. Overall, 252 respondents (74.5%) were residents and 86 (25.5%) young specialists. Two hundred and fifty-five (75.4%) respondents practiced proctology for the first time early on during their postgraduate training, but only 19.5% did it continuously for ≥ 24 months. Almost all respondents (334; 98.8%) had the chance to participate in proctological procedures, 205 (60.5%) as first surgeon. This percentage decreases according to the complexity of the surgery. In fact, only 11 (3.3%) and 24 (7.1%) of the respondents were allowed to be the first surgeon in more complex proctological diseases such as surgery for rectal prolapse and fecal incontinence. The present survey suggests that, in Italy, most surgeons in training deal with anal diseases. However, only few of them could achieve sufficient professional skills in the management of proctological diseases to be able to practice autonomously as young specialists.
肛门疾病非常常见，大多数情况下需要进行轻度或中度复杂的手术，因此是培训外科医生最容易接触到的疾病之一。本研究旨在调查意大利直肠外科学培训的现状。我们使用邮寄名单和意大利结直肠外科学会的社交媒体账户，向普通外科的住院医师和年轻专家（≤2 年）发放了一份包含 31 个问题的问卷。在 338 名回复者（53.8%为男性）中，有 252 名（74.5%）为住院医师，86 名（25.5%）为年轻专家。255 名（75.4%）回复者在研究生培训早期就首次接触直肠外科学，但只有 19.5%的人连续进行了≥24 个月的直肠外科学。几乎所有的回复者（334 名；98.8%）都有机会参与直肠手术，其中 205 名（60.5%）作为第一手术医生。这一比例根据手术的复杂程度而下降。实际上，只有 11 名（3.3%）和 24 名（7.1%）的回复者被允许作为第一手术医生进行更复杂的直肠疾病手术，如直肠脱垂和大便失禁的手术。本调查表明，在意大利，大多数培训外科医生都处理肛门疾病。然而，只有少数人能够在直肠疾病的管理方面获得足够的专业技能，从而能够作为年轻专家独立行医。
