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首页> 外文期刊>International journal of colorectal disease. >In-house colorectal laparoscopic preceptorship: a model for changing a unit's practice safely and efficiently.
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In-house colorectal laparoscopic preceptorship: a model for changing a unit's practice safely and efficiently.

机译：内部大肠腹腔镜主治学：安全有效地改变单位实践的模型。

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PURPOSE: There has been steady increase in demand for laparoscopic colonic resection as benefits are manifold compared to open and include smaller incisions, less pain, quicker recovery and convalescence, reduced morbidity and reduced analgesic demands. We devised a preceptorship programme with the aim of all four coloproctologists in our unit becoming proficient colorectal laparoscopic surgeons over a period of 12 months. METHOD: The surgeon in the unit with significant experience of laparoscopic colorectal surgery acted as a preceptor to the remaining three. A prospective database was set up to allow analysis of the impact of the preceptorship on the units' elective practice and outcomes from January 2006. RESULTS: Results were analysed 106 cases to assess the success of this novel method and were more than encouraging. During this period, 57 laparoscopic resections were performed compared 49 open resections. The proportion of patients undergoing laparoscopic resection had risen from 20% to 80% (p = 0.000). This was associated with a significant drop in post-operative stay from 14 to 4 days (p = 0.000). Analysis of patient demographics, pathology and type of resection found there to be no significant difference between the open and laparoscopic groups. The conversion rate was acceptably low (10.5%) and there were no re-admissions. CONCLUSIONS: For hospitals with the facilities and an appropriately experienced preceptor, we offer this as a patient-safe, cost-neutral method of significantly increasing a units' laparoscopic practice over a relatively short period of time.
机译：目的：腹腔镜结肠切除术的需求一直在稳定增长，因为与开放性相比，好处是多方面的，并且切口更小，疼痛更少，恢复和恢复更快，发病率降低并且止痛需求减少。我们设计了一个导师计划，目的是让我们单位中的所有四位结肠直肠科医生在12个月内成为熟练的大肠腹腔镜手术医生。方法：具有腹腔镜结直肠手术经验的单位中的外科医生是其余三个的导师。建立了一个前瞻性数据库，以分析2006年1月以来领导权对单位选修实践和结果的影响。结果：分析了106例结果，评估了该新方法的成功，令人鼓舞。在此期间，进行了57例腹腔镜切除，相比之下，进行了49例开放切除。进行腹腔镜切除术的患者比例从20％增加到80％（p = 0.000）。这与术后停留时间从14天到4天的显着下降有关（p = 0.000）。对患者的人口统计学，病理学和切除类型进行分析发现，开放组和腹腔镜组之间没有显着差异。转换率很低（10.5％），没有重新录取的机会。结论：对于具有这些设施和经验丰富的规章制度的医院，我们将其作为一种对患者安全，成本中立的方法提供，可在相对较短的时间内显着增加单位的腹腔镜检查实践。

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