Hoi Hannes, Ebner Barbara, Grünbart Martin, de Cillia Michael, Uzel Robert, Schlosser Lisa, Weiss Helmut, Mittermair Christof
Department of General and Visceral Surgery, St. John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010, Salzburg, Austria.
Department of Radiology, St. John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010, Salzburg, Austria.
Surg Endosc. 2025 Feb;39(2):830-836. doi: 10.1007/s00464-024-11410-9. Epub 2024 Dec 2.
Emergency surgery for acute bowel obstruction (ABO) is a common and occasionally technically demanding procedure, requiring both surgical skill and strategic planning. The risk entailed in teaching residents during ABO surgery has not been defined or investigated in detail to date. It is the aim of this study to reveal whether surgery for ABO, performed by resident surgeons under supervision, is safe and feasible.
A retrospective analysis was conducted of all emergency surgeries for ABO performed between 2009 and 2023 at a community-based hospital. Patients' general characteristics, procedural data and outcome parameters were compared. Differences between teaching procedures and non-teaching procedures were analysed.
The study was conducted at the Department of General and Visceral surgery at a community-based hospital (St. John of God Hospital Salzburg, Austria).
All emergency surgeries for ABO (n = 300 patients) that were performed during the study period were included.
Emergency surgery for ABO was performed in 300 patients during the study period, 15.3% of which operations were performed by residents under supervision and 84.7% by senior surgeons. No differences between these two groups were found in terms of patient characteristics, except for a past medical history of previous gynecologic or urologic surgery that was more frequent in the senior surgeon group (p = 0.02). Neither procedural data nor conversion rates from a minimally invasive (MIS) to an open (OS) approach, nor postoperative complication rates were found to be significantly different between these groups.
Emergency surgery for ABO, performed by residents under supervision, is safe and feasible, showing no significant differences in terms of complication rates, morbidity or mortality as compared to procedures performed by senior surgeons.
急性肠梗阻（ABO）的急诊手术是一种常见且有时技术要求较高的手术，既需要手术技巧又需要战略规划。迄今为止，在ABO手术期间培训住院医师所涉及的风险尚未得到明确界定或详细研究。本研究的目的是揭示在监督下由住院医师进行的ABO手术是否安全可行。
对2009年至2023年期间在一家社区医院进行的所有ABO急诊手术进行回顾性分析。比较患者的一般特征、手术数据和结局参数。分析教学手术与非教学手术之间的差异。
该研究在一家社区医院（奥地利萨尔茨堡圣约翰医院）的普通和内脏外科进行。
纳入研究期间进行的所有ABO急诊手术（n = 300例患者）。
在研究期间，300例患者接受了ABO急诊手术，其中15.3%的手术由住院医师在监督下进行，84.7%由资深外科医生进行。除了资深外科医生组既往有妇科或泌尿外科手术史的情况更常见外（p = 0.02），两组在患者特征方面未发现差异。两组在手术数据、从微创（MIS）到开放（OS）手术方式的转换率以及术后并发症发生率方面均未发现显著差异。
在监督下由住院医师进行的ABO急诊手术是安全可行的，与资深外科医生进行的手术相比，在并发症发生率、发病率或死亡率方面没有显著差异。
