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小儿结直肠外科和肛门直肠畸形的模拟与培训:范围综述。

Simulation and training for pediatric colorectal surgery and anorectal malformation: a scoping review.

机构信息

Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

Department of Liver Transplant and HepatoPancreatoBiliary Surgery, Institute of Liver and Biliary Sciences, New Delhi, India.

出版信息

Pediatr Surg Int. 2024 Jul 16;40(1):193. doi: 10.1007/s00383-024-05781-2.

DOI:10.1007/s00383-024-05781-2
PMID:39014287
Abstract

PURPOSE

To study the published literature for various models used for simulation and training in the field of pediatric colorectal surgery.

METHOD

A PubMed search was conducted for studies of simulation models in anorectal malformation on 24 March 2024 with the search words 'simulation pediatric colorectal surgery' followed by another search on 'simulation AND anorectal malformation' that gave 22 and 14 results, respectively (total 36). After removing 4 duplicate publications, 12 were found relevant to simulation and training in colorectal diseases. One publication relevant to the topic was added from literature, thirteen articles were studied.

RESULTS

Of these, 5; 1; 4; and 3 were on inanimate models; animate model; 3D reconstructions; and training, respectively. Simulation models are available for posterior sagittal anorectoplasty. The same inanimate model was used in five articles. The animate model was based on a chicken cadaver. 3D models have been made for personalized preoperative assessment and to understand the imaging in anorectal malformation. One 3D model was made by regeneration of organoid epithelium. Training modules were made to evaluate surgical dissection, standardize surgical techniques, and improve proficiency.

CONCLUSION

Simulation models are an important tool for teaching the steps of surgery and discussing the nuances of operative complications among mentors and peers. With advances in this field, the development of high-fidelity models, more training modules, and consensus on surgical techniques will benefit surgical training.

摘要

目的

研究小儿结直肠外科模拟和培训领域中使用的各种模型的已发表文献。

方法

2024 年 3 月 24 日,通过 PubMed 搜索了关于肛门直肠畸形模拟模型的研究,检索词为“模拟小儿结直肠外科”,随后又搜索了“模拟和肛门直肠畸形”,分别得到 22 项和 14 项结果(总计 36 项)。去除 4 篇重复发表的文章后,发现有 12 篇与结直肠疾病的模拟和培训相关。另有一篇与该主题相关的文献被添加,共研究了 13 篇文章。

结果

其中,5 篇、1 篇、4 篇和 3 篇分别为无生命模型、有生命模型、3D 重建和培训。模拟模型可用于后矢状位肛门直肠成形术。有 5 篇文章都使用了相同的无生命模型。有生命模型是基于鸡尸体建立的。已经制作了 3D 模型用于个性化术前评估和了解肛门直肠畸形的影像学。一个 3D 模型是通过类器官上皮的再生制作的。培训模块用于评估手术解剖、规范手术技术和提高熟练度。

结论

模拟模型是教授手术步骤和讨论导师和同行之间手术并发症细微差别的重要工具。随着该领域的发展,高保真模型、更多的培训模块以及手术技术的共识将有利于手术培训。

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本文引用的文献

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Development and validation of an objective scoring tool to evaluate surgical dissection: Dissection Assessment for Robotic Technique (DART).一种评估手术解剖的客观评分工具的开发与验证:机器人技术解剖评估(DART)。
Urol Pract. 2021 Sep;8(5):596-604. doi: 10.1097/upj.0000000000000246.
2
Surgical Simulation of Posterior Sagittal Anorectoplasty for Rectovestibular Fistula: Low-Cost High-Fidelity Animal-Tissue Model.经肛门后矢状入路直肠前庭瘘修补术的手术模拟:低成本高仿真动物组织模型。
J Pediatr Surg. 2023 Oct;58(10):1916-1920. doi: 10.1016/j.jpedsurg.2023.02.055. Epub 2023 Feb 23.
3
: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis.
一个用于生成符合PRISMA 2020标准流程图的R包和Shiny应用程序,具有交互性以实现优化的数字透明度和开放综合。
Campbell Syst Rev. 2022 Mar 27;18(2):e1230. doi: 10.1002/cl2.1230. eCollection 2022 Jun.
4
A Promising Future for Hands-On At-Home Training in Pediatric Surgery.小儿外科技能培训的未来充满希望。
Eur J Pediatr Surg. 2023 Jun;33(3):234-240. doi: 10.1055/s-0042-1745784. Epub 2022 Sep 1.
5
Validation of a Newly Developed Competency Assessment Tool for the Posterior Sagittal Anorectoplasty.经肛门后矢状入路肛门成形术新的能力评估工具的验证。
Eur J Pediatr Surg. 2022 Oct;32(5):399-407. doi: 10.1055/s-0041-1736387. Epub 2021 Nov 25.
6
Primary pulmonary Ewing's sarcoma: rare cause of massive hemothorax in a young girl-case report.原发性肺尤文肉瘤:年轻女孩大量血胸的罕见病因——病例报告。
BMC Pediatr. 2021 Apr 22;21(1):194. doi: 10.1186/s12887-021-02672-6.
7
Cysto-Vaginoscopy of a 3D-Printed Cloaca Model: A Step toward Personalized Noninvasive Preoperative Assessment in Patients with Complex Anorectal Malformations.3D 打印泄殖腔模型的阴道膀胱镜检查:在复杂性肛门直肠畸形患者中实现个性化无创术前评估的一步。
Eur J Pediatr Surg. 2022 Apr;32(2):210-214. doi: 10.1055/s-0041-1726424. Epub 2021 Mar 23.
8
The Use of an Inanimate Simulation Model for the Correction of an Anorectal Malformation in the Training of Colorectal Pediatric Surgery.在小儿肛肠外科培训中使用无生命模拟模型纠正肛肠畸形。
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9
Can complex surgical interventions be standardized? Reaching international consensus on posterior sagittal anorectoplasty using a modified-Delphi method.复杂的外科手术可以标准化吗?使用改良 Delphi 法就后矢状入路肛门直肠成形术达成国际共识。
J Pediatr Surg. 2021 Aug;56(8):1322-1327. doi: 10.1016/j.jpedsurg.2021.01.003. Epub 2021 Jan 8.
10
Three-Dimensional Regeneration of Patient-Derived Intestinal Organoid Epithelium in a Physiodynamic Mucosal Interface-on-a-Chip.在生理动态芯片上的粘膜界面中实现患者来源的肠道类器官上皮的三维再生
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