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首页> 外文期刊>Surgical Endoscopy >Impact of a full-time preceptor on the institutional outcome of laparoscopic colectomy.
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Impact of a full-time preceptor on the institutional outcome of laparoscopic colectomy.

机译：全职导师对腹腔镜结肠切除术的机构疗效的影响。

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BACKGROUND: Laparoscopic assisted colectomy (LAC) is a difficult operation with long learning curves and conversion rates inversely proportional to the surgeon's experience. Methods to help train surgeons outside of residency or fellowship programs have been poorly analyzed. This study was undertaken to assess the impact of an experienced laparoscopic surgeon preceptor on the outcome of LAC in a single institution METHODS: In September 2004, a fellowship-trained laparoscopic surgeon joined our department of surgery. This surgeon served as a LAC preceptor for six inexperienced staff surgeons and four surgical oncology fellows. Clinical and pathologic data from all attempted LAC for the 22 months preceding the arrival of the trained laparoscopic surgeon were compared with those for the 18 months following the recruitment. RESULTS: Before the addition of the expert surgeon, 28 LAC were performed in our institution, compared with 63 during the preceptor program. These represented 59% and 95% of eligible operations for each time period, respectively (P = 0.005). Overall conversion rates before and after the preceptor's arrival decreased from 44% to 14%, respectively (P < 0.05). The chances of conversion were strongly affected by the presence or absence of the preceptor in the operating room (7% vs. 30%, respectively, P = 0.003). Overall complication rates, hospital stay, blood loss, operative time and number of lymph nodes retrieved were not affected by the presence of the preceptor. Operations completed laparoscopically resulted in significantly lower blood loss and length of stay compared with converted ones. CONCLUSIONS: A shared departmental preceptor can positively affect the institutional outcome of laparoscopic colectomy. This model may help improve training and patient care in inexperienced centers.
机译：背景：腹腔镜辅助结肠切除术（LAC）是一项困难的手术，学习曲线较长，转换率与外科医生的经验成反比。对住院医师或研究金计划之外的培训外科医生的方法的分析很少。这项研究旨在评估一个经验丰富的腹腔镜外科医生对单个机构中LAC结局的影响方法：2004年9月，一名经过研究金培训的腹腔镜外科医生加入了我们的外科。这位外科医生为六名经验不足的外科医生和四名外科肿瘤学研究员提供了LAC感受器。将经过培训的腹腔镜外科医生抵达前22个月所有未曾尝试过的LAC的临床和病理数据与募集后18个月的临床和病理数据进行比较。结果：在增加专家外科医生之前，我们机构进行了28次LAC，相比之下，先导计划期间进行了63次。这些分别代表每个时期合格运营的59％和95％（P = 0.005）。感知器到达之前和之后的总转换率分别从44％下降到14％（P <0.05）。手术室中是否存在导师会极大地影响转化的机会（分别为7％对30％，P = 0.003）。总的并发症发生率，住院时间，失血量，手术时间和取回的淋巴结数目不受受体的影响。与经转换的手术相比，腹腔镜完成的手术可显着降低失血量和住院时间。结论：部门共享的受体可以积极地影响腹腔镜结肠切除术的机构疗效。该模型可以帮助改善缺乏经验的中心的培训和患者护理。

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