McFerran D J, Grant H R, Ingrams D R, Fife D G
Royal Ear Hospital, Middlesex Hospital Outpatient Department, London.
Ann R Coll Surg Engl. 1998 Sep;80(5):359-63.
Endoscopic sinus surgery (ESS) is a technique which carries great potential benefits for the treatment of many nasal conditions. However, it also carries substantial risks. The key to safe surgery lies with adequate training. A survey carried out as part of a North (East) Thames Region audit of higher surgical trainees revealed large discrepancies in their training and in their subsequent clinical practice. Almost half the trainees had started ESS without having been on a training course or performed any cadaver dissections. Despite the potential hazards of ESS, audit of complications and outcome received a low priority. The trainees made several suggestions for improving training, including better provision of courses, regional training programmes and improved access to cadavers for dissection. Other surgical specialties are being forced to examine the prospect of specific accreditation for minimally invasive techniques and otorhinolaryngology may have to follow suit.
鼻内镜鼻窦手术（ESS）是一种对多种鼻腔疾病治疗具有巨大潜在益处的技术。然而，它也存在重大风险。安全手术的关键在于充分的培训。作为泰晤士河北部（东部）地区对高级外科住院医师审计的一部分所开展的一项调查显示，他们在培训及随后的临床实践中存在很大差异。几乎一半的住院医师在未参加培训课程或未进行任何尸体解剖的情况下就开始进行鼻内镜鼻窦手术。尽管鼻内镜鼻窦手术存在潜在风险，但对并发症和手术结果的审计却未得到应有的重视。住院医师们提出了一些改进培训的建议，包括更好地提供课程、区域培训项目以及增加尸体解剖的机会。其他外科专科正被迫审视微创技术特定认证的前景，耳鼻喉科可能也不得不效仿。
