Hashimoto Kohei, Kato Daiki, Ichinose Junji, Matsuura Yosuke, Nakao Masayuki, Okumura Sakae, Kondo Haruhiko, Ohtsuka Takashi, Mun Mingyon
Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Department of Thoracic Surgery, Kyorin University, Tokyo, Japan.
JTCVS Tech. 2024 Jul 31;27:217-224. doi: 10.1016/j.xjtc.2024.07.003. eCollection 2024 Oct.
To develop a training program for bronchial sleeve reconstruction using our previously developed 3-dimensional (3D) operable airway model and evaluate its effectiveness in surgical trainees.
Eight trainees and 4 faculty surgeons were enrolled. Their right upper lobe sleeve reconstruction procedures were scored by 2 senior surgeons in a blinded fashion on a 5-point Likert scale on the following: airway wall tear, reapplied ligatures, reapplied needles, needle entry and exit, anastomotic bite, and caliber adjustment (full score: 30). The trainees were randomized into training and control groups (n = 4 in each group). The training group underwent 6 cycles of training guided by video-based instructions. The control group underwent regular clinical training. All trainees were reevaluated.
Before training, the median score of faculty surgeons was better than that of trainees (27.0 [range, 21.0-28.0] vs 17.5 [range, 9.5, 26.5]; = .05), suggesting the validity of the scoring method. The initial scores and anastomosis times were similar in the control and training groups. After training, the scores tended to be higher in the training than in the control group (median, 28.2 [range, 27.0-29.0] vs 20.8 [range, 15.0-28.0]; = .11). The anastomosis time tended to be shorter in the training group (median, 20.0 [18.9, 21.6] minutes vs 24.6 [range 17.8-30.9] minutes; = .69). The reduction in anastomosis time was significantly greater in the training group (median, -9.4 [range, -4.5 to -13.1] vs 0.0 [range, 5.3 to -6.0]; = .05).
The training program for bronchial sleeve resection using 3D airway models with video-based instructions improved the trainees' skills.
使用我们之前开发的三维（3D）可操作气道模型制定支气管袖状重建培训计划，并评估其对外科实习生的有效性。
招募了8名实习生和4名带教外科医生。由2名资深外科医生以盲法对他们的右上叶袖状重建手术进行评分，评分采用5分制李克特量表，评估内容包括：气道壁撕裂、重新结扎、重新进针、进针和出针、吻合口咬合以及管径调整（满分：30分）。将实习生随机分为训练组和对照组（每组n = 4）。训练组在基于视频的指导下进行6个周期的训练。对照组接受常规临床培训。对所有实习生进行重新评估。
训练前，带教外科医生的中位评分高于实习生（27.0[范围，21.0 - 28.0]对17.5[范围，9.5，26.5]；P = 0.05），表明评分方法的有效性。对照组和训练组的初始评分和吻合时间相似。训练后，训练组的评分往往高于对照组（中位值，28.2[范围，27.0 - 29.0]对20.8[范围，15.0 - 28.0]；P = 0.11）。训练组的吻合时间往往更短（中位值，20.0[18.9，21.6]分钟对24.6[范围17.8 - 30.9]分钟；P = 0.69）。训练组吻合时间的缩短明显更大（中位值，-9.4[范围，-4.5至-13.1]对0.0[范围，5.3至-6.0]；P = 0.05）。
使用基于视频指导的3D气道模型进行支气管袖状切除术的培训计划提高了实习生的技能。
