Öz
Amaç: Koronavirüs (COVID-19) pandemisi elektif ameliyat sayıları üzerinde belirgin bir değişime neden olmuştur. Bu değişimin genel cerrahi uzmanlık eğitimini etkilemesi olasıdır. Fıtık cerrahisi genel cerrahi eğitiminin temel bir öğesidir. Bu çalışmanın amacı, pandemi dönemini bir yıl önceki aynı dönemle karşılaştırmak ve fıtık ameliyatı sayısındaki değişimden yola çıkarak pandeminin genel cerrahi uzmanlık eğitimi üzerindeki etkisini ortaya koymaktır.
Gereç ve Yöntem: Çalışmaya Nisan- Aralık 2019 (Kontrol grubu) ve Nisan- Aralık 2020 (Pandemi Grubu) tarihleri arasında yapılan elektif karın duvarı fıtığı ameliyatları dahil edildi. Elektronik hasta dosyaları retrospektif olarak taranarak ameliyat verileri elde edildi. İki grup toplam vaka sayısı, eğitim amacıyla uzmanlık öğrencileri tarafından yapılan ameliyat sayısı ve vaka sayılarının aylara göre dağılımı açısından karşılaştırıldı.
Bulgular: Çalışmaya toplam 273 ameliyat dahil edildi. Kliniğimizde 2019 yılı döneminde 212 fıtık ameliyatı, 2020 yılı döneminde 61 fıtık ameliyatı uygulanmıştı (p:0.001). Uzmanlık öğrencileri tarafından yapılan fıtık ameliyatı sayısı 2019 yılında 88 iken 2020 yılında 18’di (p:0,009). Pandemi döneminde toplam fıtık ameliyatı sayısındaki ve uzmanlık öğrencileri tarafından yapılan ameliyat sayısındaki azalma istatiksel olarak anlamlıydı. Pandemi öncesi dönemde vakaların % 41,5’i, pandemi döneminde ise vakaların % 29,5’i uzmanlık öğrencileri tarafından uygulanmıştı. Ameliyatların asistanlar tarafından yapılma oranında gruplar arasında istatiksel olarak anlamlı fark saptanmadı (p:0,103)
Sonuç: COVID-19 pandemisi döneminde elektif fıtık ameliyatı sayısı ve uzmanlık öğrencileri tarafından yapılan ameliyat sayısı azalmıştır. Cerrahi uygulamanın eğitimin önemli bir parçası olduğu göz önüne alındığında, vaka sayısındaki düşüş ve uzmanlık öğrencilerinin ameliyatlara katılımındaki azalma eğitimin kalitesini etkileyecektir. Bu sonuçlar, pandemi döneminde uzmanlık öğrencisi eğitiminin yeniden düzenlenmesi gerektiğini ortaya koymaktadır.
Anahtar Kelimeler
Kaynakça
- www.who.int [homepage on the Internet]. WHO - Coronavirus disease 2019 (COVID-19) Situation Report [updated 12 March 2020; cited 24 May 2021] Available from: 20200312-sitrep-52-covid-19.pdf (who.int)
- Stabilini C, East B, Fortelny R, et al. European Hernia Society (EHS) guidance for the management of adult patients with a hernia during the COVID-19 pandemic. Hernia. 2020; 24 (5): 977-83.
- Hope C, Reilly JJ, Griffiths G, Lund J, Humes D. The impact of COVID-19 on surgical training: a systematic review. Tech Coloproctol. 2021; 1:3.
- tuk.saglik.gov.tr [homepage on the Internet]. Tıpta Umanlık Kurulu Genel Cerrahi Uzmanlık Eğitimi Çekirdek Müfredatı [cited 24 May 2021] Available from: v 2.4 dokümanları (saglik.gov.tr)
- Zahiri HR, Park AE, Pugh CM, Vassiliou M, Voeller G. “See one, do one, teach one”: inadequacies of current methods to train surgeons in hernia repair. Surg Endosc. 2015; 29 (10): 2867-72.
- Elsey EJ, Griffiths G, Humes DJ, West J. Meta-analysis of operative experiences of general surgery trainees during training. Br J Surg. 2016; 104 (1): 22-33.
- Maruthappu M, Duclos A, Lipsitz SR, Orgill D, Carty MJ. Surgical learning curves and operative efficiency: A cross-specialty observational study. BMJ Open. 2015; 5 (3): 1-6.
- Joyce DP, Ryan D, Kavanagh DO, Traynor O, Tierney S. Impact of COVID-19 on operative experience of junior surgical trainees. Br J Surg. 2021; 108 (1): e33-e34.
- Megaloikonomos PD, Thaler M, Igoumenou VG, et al. Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe. Int Orthop. 2020; 44 (9): 1611-9.
- Amparore D, Claps F, Cacciamani GE, et al. Impact of the COVID-19 pandemic on urology residency training in Italy. Minerva Urol e Nefrol. 2020; 72 (4): 505-9.
- Ellison EC, Spanknebel K, Stain SC, et al. Impact of the COVID-19 Pandemic on Surgical Training and Learner Well-Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators. J Am Coll Surg. 2020; 231 (6): 613-26.
- Lu J, Cuff RF, Mansour MA. Simulation in surgical education. Am J Surg. 2021; 221 (3): 509-14.
- Tuma F, Kamel MK, Shebrain S, Ghanem M, Blebea J. Alternatives surgical training approaches during COVID-19 pandemic. Ann Med Surg. 2021; 62: 253-7.
- Ferriss JS, Rose S, Rungruang B, et al. Society of Gynecologic Oncology recommendations for fellowship education during the COVID-19 pandemic and beyond: Innovating programs to optimize trainee success. Gynecol Oncol. 2021; 160 (1): 271-8.
- Christopher Ellison FACS E, Shabahang FACS MM. COVID-19 Pandemic and the Need for Disaster Planning in Surgical Education. Vol 232.; 2021. doi:10.1016/j.jamcollsurg.2020.10.008
Öz
Aim: The coronavirus disease (COVID-19) pandemic has caused a significant change in the number of elective surgeries. This change is likely to affect general surgery residency training. Hernia surgery is an essential element of general surgery training. The aim of this study is to compare the pandemic period with the same period a year ago and to reveal the effect of the pandemic on the general surgery residency training, based on the change in the number of hernia operations.
Materials and Methods: Elective abdominal wall hernia surgeries performed between April-December 2019 (control group) and April-December 2020 (Pandemic Group) were included in the study. Surgical data were obtained from electronic patient files retrospectively. The two groups were compared in terms of the total number of cases, the number of surgeries performed by residents for educational purposes, and the distribution of cases by month.
Results: A total of 273 surgeries were included in the study. In our clinic, 212 hernia surgeries were performed in 2019 period and 61 hernia operations in 2020 period (p: 0.001). The number of hernia surgeries performed by residents was 88 in 2019 and 18 in 2020 (p: 0.009). During the pandemic period, the decrease in the total number of hernia operations and the number of surgeries performed by residents was statistically significant. 41.5% of the cases in the pre-pandemic period and 29.5% of the cases during the pandemic period were applied by the residents. No statistically significant difference was found between the groups in the rate of operations performed by residents (p: 0.103)
Conclusion: During the Covid 19 pandemic, the number of elective hernia surgeries and the number of surgeries performed by residents decreased. Considering that surgical practice is an important part of education, the decrease in the number of cases and the decrease in the participation of residents to the surgeries will affect the quality of education. These results reveal that residency student education should be reorganized during the pandemic period.
Anahtar Kelimeler
Kaynakça
- www.who.int [homepage on the Internet]. WHO - Coronavirus disease 2019 (COVID-19) Situation Report [updated 12 March 2020; cited 24 May 2021] Available from: 20200312-sitrep-52-covid-19.pdf (who.int)
- Stabilini C, East B, Fortelny R, et al. European Hernia Society (EHS) guidance for the management of adult patients with a hernia during the COVID-19 pandemic. Hernia. 2020; 24 (5): 977-83.
- Hope C, Reilly JJ, Griffiths G, Lund J, Humes D. The impact of COVID-19 on surgical training: a systematic review. Tech Coloproctol. 2021; 1:3.
- tuk.saglik.gov.tr [homepage on the Internet]. Tıpta Umanlık Kurulu Genel Cerrahi Uzmanlık Eğitimi Çekirdek Müfredatı [cited 24 May 2021] Available from: v 2.4 dokümanları (saglik.gov.tr)
- Zahiri HR, Park AE, Pugh CM, Vassiliou M, Voeller G. “See one, do one, teach one”: inadequacies of current methods to train surgeons in hernia repair. Surg Endosc. 2015; 29 (10): 2867-72.
- Elsey EJ, Griffiths G, Humes DJ, West J. Meta-analysis of operative experiences of general surgery trainees during training. Br J Surg. 2016; 104 (1): 22-33.
- Maruthappu M, Duclos A, Lipsitz SR, Orgill D, Carty MJ. Surgical learning curves and operative efficiency: A cross-specialty observational study. BMJ Open. 2015; 5 (3): 1-6.
- Joyce DP, Ryan D, Kavanagh DO, Traynor O, Tierney S. Impact of COVID-19 on operative experience of junior surgical trainees. Br J Surg. 2021; 108 (1): e33-e34.
- Megaloikonomos PD, Thaler M, Igoumenou VG, et al. Impact of the COVID-19 pandemic on orthopaedic and trauma surgery training in Europe. Int Orthop. 2020; 44 (9): 1611-9.
- Amparore D, Claps F, Cacciamani GE, et al. Impact of the COVID-19 pandemic on urology residency training in Italy. Minerva Urol e Nefrol. 2020; 72 (4): 505-9.
- Ellison EC, Spanknebel K, Stain SC, et al. Impact of the COVID-19 Pandemic on Surgical Training and Learner Well-Being: Report of a Survey of General Surgery and Other Surgical Specialty Educators. J Am Coll Surg. 2020; 231 (6): 613-26.
- Lu J, Cuff RF, Mansour MA. Simulation in surgical education. Am J Surg. 2021; 221 (3): 509-14.
- Tuma F, Kamel MK, Shebrain S, Ghanem M, Blebea J. Alternatives surgical training approaches during COVID-19 pandemic. Ann Med Surg. 2021; 62: 253-7.
- Ferriss JS, Rose S, Rungruang B, et al. Society of Gynecologic Oncology recommendations for fellowship education during the COVID-19 pandemic and beyond: Innovating programs to optimize trainee success. Gynecol Oncol. 2021; 160 (1): 271-8.
- Christopher Ellison FACS E, Shabahang FACS MM. COVID-19 Pandemic and the Need for Disaster Planning in Surgical Education. Vol 232.; 2021. doi:10.1016/j.jamcollsurg.2020.10.008
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Haziran 2021 |
| Gönderilme Tarihi | 30 Nisan 2021 |
| Yayımlandığı Sayı | Yıl 2021 |