Gross R D, Sheridan M F, Burgess L P
Division of Otolaryngology, Head and Neck Surgery, Tripler Army Medical Center, Hawaii 96859-5000, U.S.A.
Laryngoscope. 1997 Aug;107(8):1080-5. doi: 10.1097/00005537-199708000-00014.
Otolaryngology has seen a rapid proliferation of functional endoscopic sinus surgery, and there is variability in the teaching of the procedure, in part because of the seriousness of the complications. A retrospective review of 106 consecutive cases was conducted at a teaching program to evaluate complications. Complication rates were combined and compared with the reported complication rates of other teaching programs and practicing otolaryngologists. The complication rate in our program was 13.9%; all were minor complications. This compared favorably with the rates of other programs (6% to 29%). The combined complication rate for residency training programs (16.6%) was significantly greater than the nonresident complication rate (10.5%). When divided into major and minor complications, the resident minor complication rate (15.9%) was significantly greater than the nonresident rate (8%), yet the major complication rates were significantly less for the resident group (0.7%) than for the nonresident group (2.5%). In addition, complications were significantly greater when procedures were performed under general anesthesia as compared with local anesthesia, and estimated blood loss was significantly greater under general anesthesia.
耳鼻喉科学领域中，功能性鼻内镜鼻窦手术迅速普及，该手术的教学存在差异，部分原因在于并发症的严重性。在一个教学项目中，对106例连续病例进行了回顾性研究以评估并发症情况。将并发症发生率汇总，并与其他教学项目及执业耳鼻喉科医生报告的并发症发生率进行比较。我们项目中的并发症发生率为13.9%；均为轻微并发症。这一结果优于其他项目（6%至29%）。住院医师培训项目的综合并发症发生率（16.6%）显著高于非住院医师的并发症发生率（10.5%）。当分为严重并发症和轻微并发症时，住院医师的轻微并发症发生率（15.9%）显著高于非住院医师（8%），然而住院医师组的严重并发症发生率（0.7%）显著低于非住院医师组（2.5%）。此外，与局部麻醉相比，全身麻醉下进行手术时并发症显著更多，且全身麻醉下的估计失血量显著更多。
