Zhu Shaojin, Lerut Toni, Jiang Xiaogan
Department of Thoracic Surgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China.
Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
J Thorac Dis. 2024 Nov 30;16(11):7885-7904. doi: 10.21037/jtd-24-1913. Epub 2024 Nov 26.
Thoracoscopic surgery training is a critical area in medical education, and understanding the trends and focus areas in this field is vital for enhancing training programs and guiding future research. The study aimed to retrospectively analyze the effects of two training methods for new students in actual thoracoscopic surgery and to summarize the development and trends of research in thoracoscopic surgery training through a bibliometric analysis of the relevant academic literature.
72 cases of thoracic surgery students were retrospectively analyzed and divided into observation group (n=36) and control group (n=36) according to different periods. The trainees in the control group underwent conventional instruction via book-based mapping of the chest anatomy, and those in the observational group were educated via preoperative interpretation of chest computed tomography (CT) 3D reconstruction combined with review of the related surgical videos and thoracoscopic procedures. The efficacies of these two methods were evaluated and assessed upon completion of the training session. Additionally, a comprehensive literature search was conducted on the Web of Science Core Collection (WoSCC) on May 27, 2024. VOSviewer, CiteSpace and the R-based online toolkit Shiny were employed for the bibliometric analysis, which facilitated the visualization of collaborations, keyword co-occurrences, and emerging research trends.
The intraoperative performance of the trainees in the observational group was significantly better than that of those in the control group in practice, including positioning and directing the shaft of the thoracoscope, interference with other devices, conversion of the near and far views, correct orientation of the lens, ensuring the operating point projected at the center of the video, cooperation with the operator, image clarity, stability of the video, the angle of the video camera lens and adjustment of the lens angle, among others (all P values <0.05). A total of 956 articles published from 1992 to 2024 were included in the study. These publications were contributed by 5,217 authors from 2,603 institutions across 289 countries. Hansen Henrik Jessen was identified as one of the most prolific authors. The University of Copenhagen emerged as the most productive institution. The journal was identified as a prominent publisher in this field. The keyword "experience" was the most frequently occurring term.
Preoperative interpretation of chest CT 3D reconstruction combined with the review of surgical videos for training the camera holders in thoracic surgery can greatly improve the performance and accelerate the training of the assistant during the procedure. Additionally, this bibliometric analysis highlight the importance of clinical experience and the integration of new surgical techniques and training methods. Future research should focus on advanced training methods and simulation-based learning to accelerate skill acquisition and proficiency.
胸腔镜手术培训是医学教育中的一个关键领域，了解该领域的趋势和重点领域对于加强培训计划和指导未来研究至关重要。本研究旨在回顾性分析两种培训方法对胸腔镜手术新手学员的实际效果，并通过对相关学术文献的文献计量分析总结胸腔镜手术培训研究的发展和趋势。
回顾性分析72例胸外科学生病例，并根据不同时期分为观察组（n = 36）和对照组（n = 36）。对照组学员通过基于书本的胸部解剖图谱进行传统教学，观察组学员则通过术前胸部计算机断层扫描（CT）三维重建解读，并结合相关手术视频和胸腔镜操作回顾进行教学。培训结束后对这两种方法的效果进行评估。此外，于2024年5月27日在科学网核心合集（WoSCC）上进行了全面的文献检索。使用VOSviewer、CiteSpace和基于R的在线工具包Shiny进行文献计量分析，以促进合作关系、关键词共现和新兴研究趋势的可视化。
在实际操作中，观察组学员的术中表现明显优于对照组，包括胸腔镜的定位与方向引导、对其他器械的干扰、远近视野转换、镜头正确定向、确保操作点投影在视频中心、与术者配合、图像清晰度、视频稳定性、摄像机镜头角度及镜头角度调整等方面（所有P值<0.05）。本研究纳入了1992年至2024年发表的956篇文章。这些出版物由来自289个国家2603个机构的5217位作者撰写。汉森·亨里克·杰森被确定为最高产作者之一。哥本哈根大学是产出最多的机构。该期刊被确定为该领域的杰出出版商。关键词“经验”是出现频率最高的术语。
术前胸部CT三维重建解读并结合手术视频回顾用于胸外科持镜助手培训，可显著提高其术中表现并加速培训进程。此外，该文献计量分析突出了临床经验以及新手术技术与培训方法整合的重要性。未来研究应聚焦于先进培训方法和基于模拟的学习，以加速技能获取和熟练程度提升。
