Raj Prince, Losty Paul D, Corbally Martin T
Department of Pediatric Surgery, King Hamad University Hospital, Royal Medical Services, Kingdom of Bahrain.
Institute of Systems Molecular and Integrative Biology University of Liverpool, UK; Department of Paediatric Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Pediatr Surg. 2024 Aug;59(8):1605-1610. doi: 10.1016/j.jpedsurg.2024.02.019. Epub 2024 Feb 26.
Is vascular training in paediatric surgical oncology considered desirable ?
A voluntary survey of work practice was undertaken with the surgeon membership of The International Society Of Paediatric Surgical Oncology (IPSO) using a structured designed questionnaire.
A total of 149 IPSO surgeon members completed the survey. 57% (N = 84) of surgeons surveyed had no specific training in vascular surgery. 43% surgeons (N = 63) stated they had acquired some skills in residency training and/or with transplantation surgery. 65% (N = 96) of respondent surgeons stated that vascular surgical training must be incorporated into pediatric surgical oncology training and 27% (N = 40) agreed that it was considered desirable. 89% (N = 133) of surgeon respondents had encountered major vascular injury during work practice while operating on pediatric solid tumors. Vascular injury repairs were undertaken and attempted by pediatric surgeons though expert assistance of vascular surgeons proved crucially essential in many instances. Emergent operations included patch repairs, vessel ligation techniques and insertion of vascular graft prostheses. Interventional radiology services to arrest life-threatening hemorrhage were also reportedly utilized by respondents.
Vascular injuries have significant potential for devastating patient outcomes including never event 'mortality'. The IPSO surgeon survey highlights that there are visible 'gaps' in skills training. Training to be a pediatric oncology surgeon must incorporate acquisition of skill sets proficiency in vascular surgery.
小儿外科肿瘤学中的血管训练是否被认为是必要的？
采用结构化设计的问卷，对国际小儿外科肿瘤学会（IPSO）的外科医生会员进行了一项关于工作实践的自愿调查。
共有149名IPSO外科医生会员完成了调查。57%（N = 84）的受访外科医生没有接受过血管外科的专门培训。43%的外科医生（N = 63）表示他们在住院医师培训和/或移植手术中获得了一些技能。65%（N = 96）的受访外科医生表示，血管外科训练必须纳入小儿外科肿瘤学培训，27%（N = 40）的人同意这被认为是必要的。89%（N = 133）的受访外科医生在小儿实体瘤手术的工作实践中遇到过重大血管损伤。小儿外科医生进行并尝试了血管损伤修复，尽管在许多情况下，血管外科医生的专家协助被证明至关重要。紧急手术包括补片修复、血管结扎技术和血管移植假体的植入。据报道，受访者还利用了介入放射学服务来阻止危及生命的出血。
血管损伤有极大可能导致毁灭性的患者结局，包括严重不良事件“死亡”。IPSO外科医生调查强调了技能培训中存在明显“差距”。成为小儿肿瘤外科医生的培训必须包括掌握血管外科的技能。
