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并发症会给外科医生带来负担吗?代谢与减重手术中的“二次受害者综合征”

Do Complications Weight on Surgeons? Second Victim Syndrome in Metabolic and Bariatric Surgery.

作者信息

Infantes Pauline, Papini Federica, Domingues Anna, Sacuto Julie, Lazzati Andrea, Jung Camille, Paolino Luca

机构信息

Centre Hospitalier Intercommunal de Créteil, Creteil, France.

Hôpital Avicenne, Bobigny, France.

出版信息

Obes Surg. 2025 May;35(5):1726-1732. doi: 10.1007/s11695-025-07824-6. Epub 2025 Mar 31.

Abstract

BACKGROUND

Although complications primarily affect patients, they also seem to cause repetitive trauma for surgeons. The concept of the "second victim" was introduced by Dr. A. Wu in 2000. This study aims to analyze the psychological impact of serious complications on metabolic and bariatric surgeons.

METHODS

The target population included all metabolic and bariatric surgeons who are members of the Société Française et Francophone de Chirurgie de l'Obésité et Maladies Métaboliques (SOFFCO.MM). A questionnaire was developed by two surgeons, and refined by a group of psychologists.

RESULTS

A total of 130 participants completed the questionnaire. Serious adverse effect affected surgical practice and professional confidence in 41.3% of cases, and had negative repercussions at family level in 39.7% of respondents. These complications led to feelings of guilt, anxiety and sleep disorders (53.7%, 53.7%, 44.6%). Excessive workload, a macho culture and a lack of communication within the team were the main obstacles to seeking help (60.3%, 47.1%, 40.5%). Women and young surgeons (30-40 years) were more affected by complications in their surgical practice and self-confidence (p = 0.03 and p = 0.019). Neither regular physical activity nor meditation showed any significant benefit in mitigating these effects.

CONCLUSIONS

This study highlights the significant psychological burden that serious complications impose on metabolic and bariatric surgeons. Due to a lack of institutional support, surgeons often manage emotional distress privately rather than professionally. Urgent action is needed to implement comprehensive support systems.

摘要

背景

尽管并发症主要影响患者,但它们似乎也给外科医生带来了反复的创伤。“第二受害者”的概念由吴医生于2000年提出。本研究旨在分析严重并发症对代谢和减重外科医生的心理影响。

方法

目标人群包括法国及法语国家肥胖与代谢疾病外科学会(SOFFCO.MM)的所有代谢和减重外科医生。一份问卷由两名外科医生编制,并由一组心理学家进行完善。

结果

共有130名参与者完成了问卷。严重不良影响在41.3%的病例中影响了手术操作和职业信心,在39.7%的受访者中对家庭层面产生了负面影响。这些并发症导致了内疚感、焦虑和睡眠障碍(分别为53.7%、53.7%、44.6%)。工作量过大、大男子主义文化以及团队内部缺乏沟通是寻求帮助的主要障碍(分别为60.3%、47.1%、40.5%)。女性和年轻外科医生(30 - 40岁)在手术操作和自信心方面受并发症影响更大(p = 0.03和p = 0.019)。规律的体育活动和冥想在减轻这些影响方面均未显示出显著益处。

结论

本研究强调了严重并发症给代谢和减重外科医生带来的巨大心理负担。由于缺乏机构支持,外科医生往往私下而非专业地应对情绪困扰。需要采取紧急行动来实施全面的支持系统。

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